■ List the pathologic subtypes of mucinous ovarian neoplasms. ■ Describe the main pathologic features of mucinous ovarian neoplasms. ■ Recognize the imaging features of mucinous ovarian neoplasms.

Background: Although the incidence of cervical cancer among younger Black women is now equivalent to that of White women, it is unknown whether the reduced incidence has affected survival rates among younger Black women. The goal of this study was to assess differences in survival by age and race. Patients and Methods: A retrospective cohort study was performed using the National Cancer Database to analyze women with nonmetastatic cervical cancer diagnosed between 2004 and 2014. Women with unknown survival data and those who died within 3 months of diagnosis were excluded. Multivariable logistic regression models evaluated interactions between age and race (Black vs non-Black) for presentation with stage I disease and receipt of optimal treatment. A multivariable Cox regression model was used to evaluate survival differences by age and race. Results: Of 55,659 women included, 16.4% were Black. Compared with their non-Black counterparts, fewer Black women presented with stage I disease (37.8% vs 47.8%; P<.01) and received optimal treatment (46.2% vs 58.3%; P<.01). Fewer Black women had private insurance if they were aged <65 years (39.6% vs 55.7%; P<.01), but not if they were aged ≥65 years (11.7% vs 12.4%; P=.43). According to multivariable logistic regression, Black women aged ≤39 years were less likely to present with stage I disease, with a significant interaction term between age and race (P<.01 for interaction). Disparities in overall survival by race were greatest for Black women aged ≤39 years (adjusted hazard ratio, 1.32; 95% CI, 1.20–1.46; P<.01) but decreased with increasing age interval until no disparity was noted for women aged ≥65 years (P<.01 for interaction). Conclusions: Younger Black women with cervical cancer are at risk for presenting with higher-stage disease and having worse overall survival. These findings may be related to insurance-related disparities and inadequate follow-up for abnormal Papanicolaou test results. Younger Black women with cervical cancer may be a particularly vulnerable population.

IMPACT: This study assesses patient and volumetric risk factors for distant recurrence within 6 months of completion of curative chemoradiation with brachytherapy in locally advanced cervical cancer. OBJECTIVES/GOALS: Initial tumor volume and tumor shrinkage velocity are prognostic of cure and survival after curative chemoradiation (CRT) for cervical cancer. We explored whether local tumor volumetric changes influence time to distant recurrences outside the radiation field. METHODS/STUDY POPULATION: We performed a retrospective cohort study of patients with FIGO Stage IB-IVA cervical cancer treated with curative CRT and brachytherapy at a tertiary academic center with minimum 3 months follow up and standard post-treatment FDG-PET. Patients received 6 weekly fractions of brachytherapy interdigitated with external beam radiation and cisplatin. Tumor volumes were assessed by MRI at brachytherapy planning. Patients who developed distant metastasis were classified as earliest (3-6 months), early (6-24 months) or late (>24 months) following completion of CRT. Absolute

Background:Glucocorticoids (GC) are used in the treatment of various inflammatory conditions and it is estimated that about 1% of US population is treated with long term steroids. High doses of GC particularly those used by rheumatologists have adverse effects on bone health and is associated with rapid bone loss resulting in Glucocorticoid induced Osteoporosis(GIO) and an increased risk of fractures. The risk of bone loss relates to high daily dose and the high cumulative dose of the GC.Despite the availability of effective preventative and treatment options, GIO is often under treated with many patients treated only after a fracture has occurred.Objectives:The purpose of this study was to examine if providing education to care providers lead to an improvement in the identification, evaluation, and treatment of GIO.Methods:This is a single center, prospective study that was performed at a university based tertiary referral center. Patients over 40 years, receiving a total cumulative dose of GC of >5 grams and/or a single dose of >30 mg of prednisone or equivalent was enrolled. A patient list was generated by our technology group. All providers received intervention in the form of an academic Journal Club, at which the current ACR guidelines regarding GIO was reviewed. Monthly reminders were shared with all providers within our monthly communications.All the pre and post interventional data was analyzed. The continuous variables were analyzed using T-test or Mann-Whitney U test. Categorical variables were analyzed using Chi-square Tests or Fisher’s exact tests. Statistical analysis was performed using SAS9.4, and p value <0.05 was considered statistically significant.Results:Post education, there was a statistically significant increase in vitamin D replacement and the use of bisphosphonates as well as a reduction in the use of bone mineral density (BMD) tests within the at risk group while on GC.Table 1.Glucocorticoid induced Osteoporosis (GIO)Pre-treatment(N=72)Post-treatment(N=54)p-valueDemographicsAge (years)58.9 ± 19.264.2 ± 16.70.11Body Mass Index29.0 ± 6.729.4 ± 8.40.77Gender (Female)73.6%74.1%0.95RaceWhite83.3%77.8%0.43Hispanic1.4%5.6%0.31InsuranceANTHEM BCBS16.9%26.9%Commercial11.3%11.5%Medicaid12.7%9.6%Medicare59.2%51.9%0.58Medical HistoryOsteoporosis68.1%64.8%0.70Osteoporotic Fracture15.3%11.1%0.50Vasculitis26.4%22.2%0.59Systemic Lupus Erythematosus18.1%13.0%0.44Rheumatoid Arthritis12.5%25.9%0.05Polymyalgia Rheumatica6.9%11.1%0.41Inflammatory Muscle Disease18.1%20.4%0.74Spondyloarthritis1.4%1.9%0.99Lab ResultsSerum Vitamin D (Normal)41.3% (19/46)52.8% (19/36)0.3GIO Prevention MeasuresCalcium2.8%13.0%0.04Vitamin D18.1%61.1%<0.01Bisphosphonates9.7%35.2%<0.01RANKL inhibitors4.2%11.1%0.17Bone Mineral Density43.5% (10/23)10.5% (2/19)0.02Conclusion:There was a significant improvement between the GIO pre and post-educational data, with increasing use of GIO preventive measures. Importantly, there was also a reduction in BMD testing of patients while still on GC. This research show the importance of provider education as a means of disseminating information and improving the quality of patient care.References:[1]Compston J. Glucocorticoid-induced osteoporosis: an update. Endocrine. 2018 Jul;61(1):7-16. doi: 10.1007/s12020-018-1588-2.[2]2017 American college of rheumatology guideline for the prevention and treatment of Glucocorticoid-induced Osteoporosis. Arthritis & Rheumatology Vol. 69, No. 8, august 2017, pp 1521-1537. DOI 10.1002/art.40137.[3]Fardet L, Petersen I, Nazareth I. Monitoring of patients on long-term glucocorticoid therapy: a population-based cohort study. Medicine (Baltimore). 2015 Apr;94(15):e647. doi: 10.1097/MD.0000000000000647.Disclosure of Interests:None declared

Hypothesis: Cervical cancer patients ineligible for brachytherapy due to tumor geometry suffer poor local control and survival outcomes despite treatment with concurrent IMRT and chemotherapy.