A multidisciplinary surgical approach implemented by gynaecological oncology experts at the Mater Hospital has improved outcomes for women with advanced ovarian cancer to the extent that patients are approximately 70% less likely to die three-years post surgery. The new study published in the Annals of Surgical Oncology, which also noted a decrease in rates of disease progression, focused on two cohorts of patients diagnosed with advanced ovarian cancer and treated at the Mater Hospital from 2006-2015 and 2017-2021 respectively.
In 2017, the Mater Hospital’s Department of Gynaecological Oncology adopted a multidisciplinary surgical approach to patients with advanced ovarian cancer which has allowed for greater rates of cytoreduction, or complete removal of all sites of cancer within the abdominal cavity. As a result, this study has noted a decrease in the mortality rate from 64.5% of patients three-years post surgery to 24%.
Senior author of the study, Professor Donal Brennan, Consultant Gynaecological Oncologist at the Mater Hospital and Professor of Gynaecological Oncology at UCD School of Medicine, said: “Ovarian cancer is a complicated disease that requires input from multiple specialties including medical oncology, pathology, radiology and surgery. Extensive surgery is often required and we believe that collaboration between different surgical specialities allows us to safely perform aggressive operations to remove all visible tumours from the abdomen which is the single greatest predictor of improved survival. The study supports the growing body of international evidence that patients with ovarian cancer have better outcomes when managed in centralised specialised oncology centres, such as the Mater.”
In order to combat late-stage disease, the collaborative multidisciplinary environment allows for gynaecological oncologists as well as colorectal, hepatobiliary and upper gastrointestinal surgeons to carefully plan surgical resections and subsequent treatment. These types of complex surgeries involve multiple specialists and can take up to ten hours to perform. This new research also shows that disease progression three years after surgery and chemotherapy has reduced from 75% in the first cohort of patients, to under 50% in the second - a decrease of more than 35%.
Jürgen Mulsow, Consultant General and Colorectal Surgeon at the Mater, said: “As part of our multidisciplinary approach to advanced cancer, we at the Mater Hospital collaborate with colleagues to select the most suitable patients for surgery. This collaboration ensures that patients receive integrated medical care from the moment of consideration of surgery to full recovery and has helped us to improve both peri-operative and long-term outcomes.”
The study marks a positive step in the treatment of ovarian cancer, which is the seventh most prevalent female cancer globally and frequently presents at an advanced stage due to lack of symptom awareness. Historically, survival rates for ovarian cancer in Ireland have significantly lagged behind our European neighbours.
In May 2017, Jeannine Davis from Coolock in Dublin, received a diagnosis of advanced ovarian cancer at the age of 39. Speaking about her care at the Mater, Jeannine said: “The only symptoms I had of ovarian cancer was a swollen stomach and I was devastated to learn of my diagnosis. However, the silver lining was meeting with the gynaecological oncology team at the Mater who saved my life. I felt that I was in good hands as they meticulously planned my surgery and follow-up treatment. I encourage women to listen to their bodies and make themselves aware of the signs of gynaecological cancers.”
The UCD Gynaecological Oncology Group at the Mater Hospital has been certified as a centre of excellence for ovarian cancer in Europe. To date, as the National Centre for Peritoneal Malignancy and home to the largest ovarian cancer unit in the UK and Ireland, the Mater Hospital has performed more than 250 major cytoreductive surgeries on patients with advanced ovarian cancer.
Alan Sharp, CEO of the Mater Hospital, said: “I am proud of the great strides that my colleagues at the Mater Hospital have made in the pursuit of better patient outcomes for patients with ovarian cancer. As a leading teaching and research hospital, we are maintaining our strong track record of producing high quality treatments that deliver real and meaningful results to patients and their families.”
Professor Donal Brennan is Professor of Gynaecological Oncology at UCD and Academic Lead of the UCD Gynaecological Oncology group, the Mater Misericordiae and St Vincent’s University Hospitals. He has multiple research interests in gynaecological oncology and has led the Irish Cancer Society Women's Health Initiative at UCD which is focused on improving care for women after cancer.