463 Preoperative FDG PET/CT vs ceCT in advanced ovarian cancer

Abstract

Result(s)* 8 OCs occurred during 1277 women screen years; 2 occult OCs at RRSO (both stage 1a), 6 screen-detected OCs (3 prevalent; stage 2a, 3aii and 3c, 3 incident; stage 1a, 3b and 4b). 4 of 6 (67%) screen-detected OCs were diagnosed at stages <3c. 7 of 8 (87.5%) screen-detected cancers were completely cytoreduced. There were no interval cancers. Modelled sensitivity, specificity, PPV and NPV for OC were 87.5% (CI, 47.3-99.7), 99.9%(99.9-100), 75%(34.9-96.8) and 99.9% (99.9-100) respectively. Economic modelling indicated that surveillance would be cost-saving within the UK National Health Service. Conclusion* OC surveillance for women declining RRSO in a 'real-word' setting is feasible and equally effective as in research trials, resulting in successful downstaging with likely clinical benefit and healthcare cost savings. Whilst RRSO remains the recommended management for BRCA-carriers, ROCA-based surveillance is a viable interim option for those who defer such surgery.