382 ABSTRACTS / Gynecologic Oncology 111 (2008) 373–386

research for these pts should include and effort to define boththe optimal number of cycles to undergo pre-interval CRS aswell as define the goal of interval CRS in terms of residualdisease. For pts who receive NAC due to poor PS or age,interval CRS was performed far less often—indicating thatthere are some pts for whom the treatment plan must be purelypalliative.

doi:10.1016/j.ygyno.2008.07.080

18The impact of chemotherapy on the survival of early-stageI–II epithelial ovarian cancerR. Urban a, H. Deshmukh b, R. Zhang b, X. Yu c, J.Y. Shin a,K. Osann d, D.S. Kapp a, A. Husain a, L. Chen b, J.K. Chan b

a Stanford University School of Medicine, Stanford, CA, USAb University of California, San Francisco School of Medicine,San Francisco, CA, USAc University of Minnesota, Minneapolis, MN, USAd University of California, Irvine Medical Center, Orange,CA, USA

Objectives. To determine the survival advantage of adjuvantchemotherapy in older (N65 years) patients with stage I–IIepithelial ovarian cancer.

Methods. Data were extracted from Medicare claimsdatabase. Kaplan Meier and logistic regression analyses wereutilized for statistical analyses.

Results. Of 1087 patients with stage I–II epithelial ovariancancer, the median age was 74 years (range: 65 to 95). 976(89.79%) patients were White, 54 (4.97%) Black, 20 (1.75%)Asian, and 8 (0.74%) were Hispanic. 711 (65.4%) had stage Iand 376 (34.6%) had stage II disease. Of these tumors, 384(46.6%) were serous, 265 (32.16%) endometrioid, 102(12.38%) clear cell, and 73 (8.86%) were mucinous. 130(11.96%), 258 (24.01%), and 395 (37.2%) had grade 1, 2, and 3,respectively. 998 (94.1%) patients underwent primary surgery;of these, 75 (13.69%) involved gynecologic oncologists. 511(47.01%) received a lymph node examination with median nodecount of 48 (range: 1 to 98). Of these patients, 680 (62.5)underwent chemotherapy; of which, 381 (57.3%) were stage Iand 291 (42.7%) were stage II. Those who underwent primarysurgery had a 5-year disease-specific survival of 79% vs. 31%in those without primary surgery (pb0.0001). In the overallstudy group, chemotherapy was not associated with asignificant improved 5-year disease-specific survival. However,in those with stage IC disease, chemotherapy improved thesurvival from 64% to 74% (p=0.02). Likewise, adjuvantchemotherapy improved the survival from 47% to 65%(pb0.0001) in stage II patients. In contrast, those with low-risk disease (stage IA, grade 1–2, non-clear cell) did not haveany benefit associated with chemotherapy (88% vs. 93%;p=0.09). On multivariate analysis, age of diagnosis, primarysurgery, chemotherapy, and stage were independent prognosticfactors for survival.

Conclusion. In this population-based analysis, adjuvantchemotherapy improves the survival of early-stage, high-riskepithelial ovarian cancer.

doi:10.1016/j.ygyno.2008.07.081

19Pelvic fractures following radiation therapy for cervicalcancer: Implications for survivorsK.M. Schmeler, A. Jhingran, R.B. Iyer, C.C. Sun, P.J. Eifel,P.T. Soliman, P.T. Ramirez, M. Frumovitz, D.C. Bodurka, A.K. SoodMD Anderson Cancer Center, Houston, TX, USA

Objective. Pelvic radiotherapy has been shown to result indemineralization of bone matrix, increasing the risk ofosteoporosis and pelvic features. The objective of our studywas to determine the incidence of pelvic features in womentreated with radiotherapy for cervical cancer, and to determinerisk factors associated with these fractures.

Methods. Following IRB approval, the records of 516 womentreated with curative intent radiotherapy for cervical cancerbetween 2001 and 2006 at a single institution were reviewed.455 patients received primary radiotherapy and 61 patientsreceived adjuvant radiotherapy following surgery. Data col-lected included age at diagnosis, ethnicity, BMI, menopausalstatus, smoking history, pathologic characteristics and type andduration of radiotherapy. 300 patients had at least one post-treatment CT scan or MRI study available for review, andcomprise our study population. All imaging studies were re-reviewed by a single radiologist to evaluate for fractures.

Results. Median age at cancer diagnosis was 51 years (range25–94). 40% of patients were postmenopausal. Median BMIwas 28 kg/m2 (range 16–58). Pelvic fractures were noted in 29of 300 patients (9.7%). Fracture sites included sacrum (n=24,83%), sacrum and pubis (n=3, 10%), iliac crest (n=1, 3%), andsacrum and acetabulum (n=1, 3%). 13 patients (45%) weresymptomatic, with pain being the most common presentingsymptom. Median time from completion of radiotherapy todetection of fractures on imaging studies was 14 months (range2–63), with 38% diagnosed within 1 year and 86% diagnosedwithin 2 years of completing therapy. Median age at diagnosiswas higher in the women who developed a fracture comparedwith the women who did not (56 vs. 51 years, p=0.02). A highernumber of women with a fracture were postmenopausal (62 vs.37%, p=0.03). Median BMI was lower in the women who had afracture (26 vs. 29 kg/m2, p=0.03). There were no statisticallysignificant differences in ethnicity and smoking history betweenthe two groups. Median follow-up was 24 months (range 3–85).

Conclusions. Pelvic fractures were detected in a substantialproportion of women following radiotherapy for cervicalcancer. Bone mineral density screening and pharmacologicalintervention should be considered in these women.

doi:10.1016/j.ygyno.2008.07.083