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1868 Prognostic Value of Preoperative Lymphocyte-Monocyte Ratio in Patients with Ovarian Clear Cell Carcinoma
Abstracts / Journal of Minimally Invasive Gynecology 26 (2019) S98−S231
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The procedure was completed without any complications. Patient was discharged home on postoperative day one. The pathology revealed ovarian adenocarcinoma with negative margins. Conclusion: To optimize targeting and visualization of the surgical field in right pelvic sidewall/paracolic gutter, robotic arms can be placed in a straight line from above the pubic symphysis extending to the left subcostal line and between the midline vertical and midclavicular lines. Robotic tumor debulking should be considered in selected patients with recurrent ovarian cancer who present with oligo-metastatic disease, in the absence of carcinomatosis.
Design: This was an IRB-approved, retrospective study of opioid and benzodiazepine prescriptions for cervical, ovarian (including fallopian tube and primary peritoneal), and uterine cancer patients within a single healthcare system from January 2016 to August 2018. Demographics and prescription details were extracted from the electronic medical record. Setting: A tertiary care academic nonprofit healthcare system. Patients or Participants: Patients with ovarian, uterine, or cervical cancer that received an opioid or benzodiazepine prescription. Interventions: N/A Measurements and Main Results: 6407 prescriptions for opioids/benzodiazepines were dispensed to 3586 patients over a total of 5931 prescribing encounters for cervical (n=1965, 33%), ovarian (n=1801, 30%), or uterine cancers (n=2165, 37%). The setting for prescription distribution was 50.9% outpatient, 25.6% inpatient, and 21% emergency center. Cervical cancer patients were more likely to have received a prescription in an emergency center (p<0.0001) or from a pain/palliative care specialist (p<0.0001). Opioids were prescribed in 87%, benzodiazepines in 5.2%, and both in 6.6% of encounters. Ovarian cancer patients were more often prescribed benzodiazepines (p<0.0001), but cervical cancer patients were more often prescribed both opioids and benzodiazepines in a single encounter (p<0.0001). The mean morphine equivalent (MME) prescribed was higher for patients with cervical cancer (64.5mg) compared to ovarian (49.5mg) or uterine cancer (46.8mg) (p<0.0001). At least one risk factor for opioid abuse was noted in 22% of encounters. Cervical cancer patients were more likely to have these risk factors present (28.1%) compared with ovarian (20.2%) or uterine cancer (16.5%, p<0.0001). Cervical cancer patients also had a higher number of risk factors present (p<0.001). Conclusion: Opioid prescribing patterns differed for cervical, ovarian, and uterine cancer patients. Patients with cervical cancer were more likely to have risk factors present for opioid and benzodiazepine misuse, abuse, and diversion.
Virtual Poster Session 4: Oncology (1:30 PM — 1:40 PM) 1:30 PM: STATION S 1354 The Safety and Efficacy Of Intra-Arterial Versus Intra-Venous Neoadjuvant Chemotherapy in Patients with Locally Advanced Cervical Cancer: A MetaAnalysis Liu C,* Bai H, Zhang Z. Gynaecology and obstetrics, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China *Corresponding author. Study Objective: The aim of this study was to evaluate the safety and efficacy of intra-arterial (NCIA) versus intravenous (NCIV) neoadjuvant chemotherapy in managing patients with locally advanced cervical cancer (LACC). Design: The PubMed, EMBASE, PMC, Web of Science and Cochrane databases were searched to identify correlational studies published in English. Prospective controlled studies that evaluated the treatment effect of NCIA or NCIV in patients with LACC were pooled for a meta-analysis. Setting: N/A Patients or Participants: N/A Interventions: N/A Measurements and Main Results: A total of three eligible studies with 112 LACC patients were eventually included in this analysis. The baseline regimen of neoadjuvant chemotherapy (NACT) was platinum-based chemotherapy. The total clinical response rate (RR) was 71.4%, and the pathological complete response (PCR) was 11.5% overall. The grade 3/ 4 toxicity rate was 27.2%. In the NCIA group, the RR was 83.1% (complete response [CR], 22.0%; partial response [PR], 61.0%), which was significantly higher than the 58.5% RR (CR, 11.3%; PR, 47.2%) in the NCIV group (P=0.005). The PCR was 15.5% in the NCIA group, which was slightly higher than 6.5% PCR in the NCIV group (P=0.43). The grade 3/4 toxicity rate was 17.2% in the NCIA group, which was slightly higher than the 13.8% toxicity rate in the NCIV group (P=0.38). Conclusion: Platinum-based NACT was well tolerated in patients with LACC and showed moderate response activity. Compared to NCIV, NCIA showed an evident advantage in the clinical response with a similar toxicity rate. The clinical efficacy of NCIA deserves further evaluation. Virtual Poster Session 4: Oncology (1:30 PM — 1:40 PM) 1:30 PM: STATION T 2534 Opioid Use and Misuse among Gynecologic Oncology Patients Pena SR,1,* Brown J,2 Wally M,3 Seymour R,3 Hsu JR,3 Naumann RW2. 1 Obstetrics and Gynecology, Atrium Health, Charlotte, NC; 2Levine Cancer Institute, Atrium Health, Charlotte, NC; 3Orthopaedic Surgery, Atrium Health, Charlotte, NC *Corresponding author. Study Objective: To determine opioid and benzodiazepine prescribing practices in the gynecologic oncology population and determine if this patient population is at risk for narcotic abuse.
Virtual Poster Session 4: Oncology (1:40 PM — 1:50 PM) 1:40 PM: STATION A 1868 Prognostic Value of Preoperative LymphocyteMonocyte Ratio in Patients with Ovarian Clear Cell Carcinoma Kwon BS,* Yoon HJ, Lee HJ. Department of Obstetrics and Gynecology, Pusan National University School of Medicine, and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea, Republic of (South) *Corresponding author. Study Objective: The aim of the present study was to determine the prognostic significances of markers of preoperative systemic inflammatory response (SIR) in patients with ovarian clear cell carcinoma (OCCC). Design: A total of 109 patients diagnosed with OCCC that underwent primary cytoreductive surgery and adjuvant platinum-based chemotherapy from 2009 to 2012 were enrolled in this retrospective study. SIR markers were calculated from complete blood cell counts determined before surgery. Setting: This study was performed in Pusan National University Hospital, Busan, Korea Patients or Participants: 109 OCCC patients that had underwent primary debulking and adjuvant paclitaxel and carboplatin chemotherapy at university hospitals between April 2007 and June 2012. Interventions: Preoperative blood samples were drawn 1 to 2 weeks prior to surgery. ROC curve analysis was used to obtain optimal NLR, LMR and PLR cutoff values for predicting survival outcomes. Measurements and Main Results: The optimized NLR, LMR and PLR cut-off values as determined by ROC curve analysis for PFS and OS were 2.3, 4.2, and 123.6, respectively. When the cohort was divided using these optimized cut-offs, NLR and LMR were found to be significantly associated with clinicopathologic factors, NLR with FIGO stage, the presence of
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Abstracts / Journal of Minimally Invasive Gynecology 26 (2019) S98−S231 hysterectomy; persistent bleeding in the absence of progressive histology being the main indication. 84% (n= 26) of 2018 cohort were followed up according to 2016 Royal College of Obstetricians and Gynaecologists guidance.
malignant ascites, and platinum response, and LMR with FIGO stage, lymph node metastasis, malignant ascites, and platinum response. KaplanMeier analysis revealed a high NLR (> 2.3) was significantly associated with low 5-year PFS and OS rates and that a high LMR was significantly associated with high 5-year PFS and OS rates. Multivariate analysis identified FIGO stage, residual mass, and platinum response as independent prognostic factors of PFS, and FIGO stage, residual mass, platinum response, and LMR as independent prognostic factors of OS. Conclusion: Markers of systemic inflammatory response provide useful prognostic information and lymphocyte-to-monocyte ratio is the most reliable independent prognostic factor of overall survival in patients with ovarian clear cell carcinoma.
Conclusion: Overall hyperplasia incidence is increasing. While BMI is elevated, there was no upward trend observed. Does the insidious decline in age demographic suggest that hyperplasia is occurring in younger women? Our review did not demonstrate a continuous increase in atypia, however there was a higher incidence in the 2013 group, who were also the most obese. Adherence to best practice surveillance in our hospitals was falling short.
Virtual Poster Session 4: Oncology (1:40 PM — 1:50 PM)
Virtual Poster Session 4: Oncology (1:40 PM — 1:50 PM)
1:40 PM: STATION B
1:40 PM: STATION D
1471 Single-Site Laparoscopic Total Hysterectomy and Bilateral Pelvic Lymphadenectomy for Endometrial Cancer Kuang Y*. Obstetrics and Gynecology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China *Corresponding author.
2000 Survival Outcomes of Neoadjuvant Chemotherapy Followed By Laparoscopic or Open Radical Hysterectomy Versus Concurrent Chemoradiation in Patients with Locally Advanced Cervical Cancer Cho HW,1,* Lee JK,2 Ouh YT2. 1Korea University Guro Hospital, Seoul, Korea, Republic of (South); 2Obstetrics and Gynecology, Korea University Guro Hospital, Seoul, Korea, Republic of (South) *Corresponding author.
Video Objective: To demonstrate a reproducible technique for hysterectomy +bilateral accessory resection +pelvic lymphadenectomy. Setting: 47 year old with menstrual disorder and endometrial lesion. Interventions: Single-site laparoscopic vaginal combined hysterectomy +bilateral accessory resection +pelvic lymphadenectomy. Conclusion: Single-site laparoscopy is an alternative surgical choice for endometrial cancer. Virtual Poster Session 4: Oncology (1:40 PM — 1:50 PM) 1:40 PM: STATION C 2921 Trends in Endometrial Hyperplasia Over the Past Decade − Is It on the Increase? Skelly C,1,* Breen J,1 Johnston KM2. 1Obstetrics & Gynaecology, Antrim Area Hospital, Antrim, United Kingdom; 2Antrim Hospital, Antrim, United Kingdom *Corresponding author. Study Objective: Atypical Hyperplasia carries a 30% risk of developing endometrial cancer over 20 years. Endometrial cancer has increased by 54% since the 1998. Overall hysterectomy rates are falling, and obesity increases. We reviewed 3 snapshot years over 10 years, in terms of hyperplasia numbers, management and surveillance. Design: Retrospective case note audit with histological diagnosis of endometrial hyperplasia with or without atypia for 2008, 2013 and 2018. Setting: Northern Health and Social Care Trust, Northern Ireland Patients or Participants: 74 patients with a histological diagnosis of endometrial hyperplasia with or without atypia were identified. Interventions: Medical treatment or hysterectomy. Measurements and Main Results: Endometrial Hyperplasia incidence 2008 - 19 cases (23% atypical / 77% without atypia); 2013 - 24 cases (42% atypical /58% without atypia) and 2018 - 31 cases (29% atypical /71% without atypia). Mean BMI was 35, 39 and 36 in 2008, 2013 and 2018 respectively. Age range 33 − 80 years. Mean age 2008 - 59; 2013 - 56; 2018 - 53. 74% (n=17) with atypical hyperplasia underwent hysterectomy. 26% (n=6) had medical treatment with levonorgestrel IUS or oral progestogens, and surveillance due to surgical unsuitability or patient choice. Hyperplasia without atypia was managed conservatively with progestogens and surveillance in 71% (n= 36) whilst 29% (n= 15) underwent
Study Objective: This study aimed to compare the survival outcomes of NACT followed by laparoscopic or open radical hysterectomy versus CCRT in patients with locally advanced cervical cancer. Design: Retrospective single-center study. Setting: Retrospective single-center study. Patients or Participants: Patients who were diagnosed as cervical cancer stage Ib1 to IVA at the Korea University Guro Hospital (February 2002» March 2014). Interventions: NACT followed by laparoscopic or open radical hysterectomy versus CCRT. Measurements and Main Results: Patients were categorized into two groups according to treatment method: NACT followed by laparoscopic and open radical hysterectomy with or without adjuvant chemotherapy (NCRH group) and concurrent chemoradiation (CCRT group). Survival outcomes and morbidity of the treatment were compared between the two groups using the Kaplan-Meier’s analysis. Conclusion: Neoadjuvant chemotherapy followed by laparoscopic and open radical hysterectomy seems to be a safe treatment option for locally advanced cervical cancer, in terms of similar survival outcomes and morbidity of treatment with CCRT. However, the present study is too limited to permit conclusions due to its small sample size and retrospective design despite statistical methods for adjusting confounding factors. Virtual Poster Session 4: Laparoscopy (1:40 PM — 1:50 PM) 1:40 PM: STATION E 1206 The Effect of Sub-Cutaneous and Intra-Peritoneal Anesthesia on Post Laparoscopic Pain: A Randomized Controlled Trial Gluck O,1,* Barber E,1 Feldstein O,1 Kerner R,1 Keidar R,1 Ginath S,1 Wolfson I,2 Bar J,1 Sagiv R1. 1Obstetrics and Gynecology, E. Wolfson Medical Center, Holon, Israel; 2Operation room, E. Wolfson Medical Center, Holon, Israel *Corresponding author. Study Objective: To evaluate whether sub-cutaneous (SC) trocar site and intra-peritoneal (IP) anesthesia reduce post-operative pain. Design: This is a randomized, controlled, double-blinded trial. The patients were randomly assigned to one of 4 groups:
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The procedure was completed without any complications. Patient was discharged home on postoperative day one. The pathology revealed ovarian adenocarcinoma with negative margins. Conclusion: To optimize targeting and visualization of the surgical field in right pelvic sidewall/paracolic gutter, robotic arms can be placed in a straight line from above the pubic symphysis extending to the left subcostal line and between the midline vertical and midclavicular lines. Robotic tumor debulking should be considered in selected patients with recurrent ovarian cancer who present with oligo-metastatic disease, in the absence of carcinomatosis.
Design: This was an IRB-approved, retrospective study of opioid and benzodiazepine prescriptions for cervical, ovarian (including fallopian tube and primary peritoneal), and uterine cancer patients within a single healthcare system from January 2016 to August 2018. Demographics and prescription details were extracted from the electronic medical record. Setting: A tertiary care academic nonprofit healthcare system. Patients or Participants: Patients with ovarian, uterine, or cervical cancer that received an opioid or benzodiazepine prescription. Interventions: N/A Measurements and Main Results: 6407 prescriptions for opioids/benzodiazepines were dispensed to 3586 patients over a total of 5931 prescribing encounters for cervical (n=1965, 33%), ovarian (n=1801, 30%), or uterine cancers (n=2165, 37%). The setting for prescription distribution was 50.9% outpatient, 25.6% inpatient, and 21% emergency center. Cervical cancer patients were more likely to have received a prescription in an emergency center (p<0.0001) or from a pain/palliative care specialist (p<0.0001). Opioids were prescribed in 87%, benzodiazepines in 5.2%, and both in 6.6% of encounters. Ovarian cancer patients were more often prescribed benzodiazepines (p<0.0001), but cervical cancer patients were more often prescribed both opioids and benzodiazepines in a single encounter (p<0.0001). The mean morphine equivalent (MME) prescribed was higher for patients with cervical cancer (64.5mg) compared to ovarian (49.5mg) or uterine cancer (46.8mg) (p<0.0001). At least one risk factor for opioid abuse was noted in 22% of encounters. Cervical cancer patients were more likely to have these risk factors present (28.1%) compared with ovarian (20.2%) or uterine cancer (16.5%, p<0.0001). Cervical cancer patients also had a higher number of risk factors present (p<0.001). Conclusion: Opioid prescribing patterns differed for cervical, ovarian, and uterine cancer patients. Patients with cervical cancer were more likely to have risk factors present for opioid and benzodiazepine misuse, abuse, and diversion.
Virtual Poster Session 4: Oncology (1:30 PM — 1:40 PM) 1:30 PM: STATION S 1354 The Safety and Efficacy Of Intra-Arterial Versus Intra-Venous Neoadjuvant Chemotherapy in Patients with Locally Advanced Cervical Cancer: A MetaAnalysis Liu C,* Bai H, Zhang Z. Gynaecology and obstetrics, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China *Corresponding author. Study Objective: The aim of this study was to evaluate the safety and efficacy of intra-arterial (NCIA) versus intravenous (NCIV) neoadjuvant chemotherapy in managing patients with locally advanced cervical cancer (LACC). Design: The PubMed, EMBASE, PMC, Web of Science and Cochrane databases were searched to identify correlational studies published in English. Prospective controlled studies that evaluated the treatment effect of NCIA or NCIV in patients with LACC were pooled for a meta-analysis. Setting: N/A Patients or Participants: N/A Interventions: N/A Measurements and Main Results: A total of three eligible studies with 112 LACC patients were eventually included in this analysis. The baseline regimen of neoadjuvant chemotherapy (NACT) was platinum-based chemotherapy. The total clinical response rate (RR) was 71.4%, and the pathological complete response (PCR) was 11.5% overall. The grade 3/ 4 toxicity rate was 27.2%. In the NCIA group, the RR was 83.1% (complete response [CR], 22.0%; partial response [PR], 61.0%), which was significantly higher than the 58.5% RR (CR, 11.3%; PR, 47.2%) in the NCIV group (P=0.005). The PCR was 15.5% in the NCIA group, which was slightly higher than 6.5% PCR in the NCIV group (P=0.43). The grade 3/4 toxicity rate was 17.2% in the NCIA group, which was slightly higher than the 13.8% toxicity rate in the NCIV group (P=0.38). Conclusion: Platinum-based NACT was well tolerated in patients with LACC and showed moderate response activity. Compared to NCIV, NCIA showed an evident advantage in the clinical response with a similar toxicity rate. The clinical efficacy of NCIA deserves further evaluation. Virtual Poster Session 4: Oncology (1:30 PM — 1:40 PM) 1:30 PM: STATION T 2534 Opioid Use and Misuse among Gynecologic Oncology Patients Pena SR,1,* Brown J,2 Wally M,3 Seymour R,3 Hsu JR,3 Naumann RW2. 1 Obstetrics and Gynecology, Atrium Health, Charlotte, NC; 2Levine Cancer Institute, Atrium Health, Charlotte, NC; 3Orthopaedic Surgery, Atrium Health, Charlotte, NC *Corresponding author. Study Objective: To determine opioid and benzodiazepine prescribing practices in the gynecologic oncology population and determine if this patient population is at risk for narcotic abuse.
Virtual Poster Session 4: Oncology (1:40 PM — 1:50 PM) 1:40 PM: STATION A 1868 Prognostic Value of Preoperative LymphocyteMonocyte Ratio in Patients with Ovarian Clear Cell Carcinoma Kwon BS,* Yoon HJ, Lee HJ. Department of Obstetrics and Gynecology, Pusan National University School of Medicine, and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea, Republic of (South) *Corresponding author. Study Objective: The aim of the present study was to determine the prognostic significances of markers of preoperative systemic inflammatory response (SIR) in patients with ovarian clear cell carcinoma (OCCC). Design: A total of 109 patients diagnosed with OCCC that underwent primary cytoreductive surgery and adjuvant platinum-based chemotherapy from 2009 to 2012 were enrolled in this retrospective study. SIR markers were calculated from complete blood cell counts determined before surgery. Setting: This study was performed in Pusan National University Hospital, Busan, Korea Patients or Participants: 109 OCCC patients that had underwent primary debulking and adjuvant paclitaxel and carboplatin chemotherapy at university hospitals between April 2007 and June 2012. Interventions: Preoperative blood samples were drawn 1 to 2 weeks prior to surgery. ROC curve analysis was used to obtain optimal NLR, LMR and PLR cutoff values for predicting survival outcomes. Measurements and Main Results: The optimized NLR, LMR and PLR cut-off values as determined by ROC curve analysis for PFS and OS were 2.3, 4.2, and 123.6, respectively. When the cohort was divided using these optimized cut-offs, NLR and LMR were found to be significantly associated with clinicopathologic factors, NLR with FIGO stage, the presence of
S228
Abstracts / Journal of Minimally Invasive Gynecology 26 (2019) S98−S231 hysterectomy; persistent bleeding in the absence of progressive histology being the main indication. 84% (n= 26) of 2018 cohort were followed up according to 2016 Royal College of Obstetricians and Gynaecologists guidance.
malignant ascites, and platinum response, and LMR with FIGO stage, lymph node metastasis, malignant ascites, and platinum response. KaplanMeier analysis revealed a high NLR (> 2.3) was significantly associated with low 5-year PFS and OS rates and that a high LMR was significantly associated with high 5-year PFS and OS rates. Multivariate analysis identified FIGO stage, residual mass, and platinum response as independent prognostic factors of PFS, and FIGO stage, residual mass, platinum response, and LMR as independent prognostic factors of OS. Conclusion: Markers of systemic inflammatory response provide useful prognostic information and lymphocyte-to-monocyte ratio is the most reliable independent prognostic factor of overall survival in patients with ovarian clear cell carcinoma.
Conclusion: Overall hyperplasia incidence is increasing. While BMI is elevated, there was no upward trend observed. Does the insidious decline in age demographic suggest that hyperplasia is occurring in younger women? Our review did not demonstrate a continuous increase in atypia, however there was a higher incidence in the 2013 group, who were also the most obese. Adherence to best practice surveillance in our hospitals was falling short.
Virtual Poster Session 4: Oncology (1:40 PM — 1:50 PM)
Virtual Poster Session 4: Oncology (1:40 PM — 1:50 PM)
1:40 PM: STATION B
1:40 PM: STATION D
1471 Single-Site Laparoscopic Total Hysterectomy and Bilateral Pelvic Lymphadenectomy for Endometrial Cancer Kuang Y*. Obstetrics and Gynecology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China *Corresponding author.
2000 Survival Outcomes of Neoadjuvant Chemotherapy Followed By Laparoscopic or Open Radical Hysterectomy Versus Concurrent Chemoradiation in Patients with Locally Advanced Cervical Cancer Cho HW,1,* Lee JK,2 Ouh YT2. 1Korea University Guro Hospital, Seoul, Korea, Republic of (South); 2Obstetrics and Gynecology, Korea University Guro Hospital, Seoul, Korea, Republic of (South) *Corresponding author.
Video Objective: To demonstrate a reproducible technique for hysterectomy +bilateral accessory resection +pelvic lymphadenectomy. Setting: 47 year old with menstrual disorder and endometrial lesion. Interventions: Single-site laparoscopic vaginal combined hysterectomy +bilateral accessory resection +pelvic lymphadenectomy. Conclusion: Single-site laparoscopy is an alternative surgical choice for endometrial cancer. Virtual Poster Session 4: Oncology (1:40 PM — 1:50 PM) 1:40 PM: STATION C 2921 Trends in Endometrial Hyperplasia Over the Past Decade − Is It on the Increase? Skelly C,1,* Breen J,1 Johnston KM2. 1Obstetrics & Gynaecology, Antrim Area Hospital, Antrim, United Kingdom; 2Antrim Hospital, Antrim, United Kingdom *Corresponding author. Study Objective: Atypical Hyperplasia carries a 30% risk of developing endometrial cancer over 20 years. Endometrial cancer has increased by 54% since the 1998. Overall hysterectomy rates are falling, and obesity increases. We reviewed 3 snapshot years over 10 years, in terms of hyperplasia numbers, management and surveillance. Design: Retrospective case note audit with histological diagnosis of endometrial hyperplasia with or without atypia for 2008, 2013 and 2018. Setting: Northern Health and Social Care Trust, Northern Ireland Patients or Participants: 74 patients with a histological diagnosis of endometrial hyperplasia with or without atypia were identified. Interventions: Medical treatment or hysterectomy. Measurements and Main Results: Endometrial Hyperplasia incidence 2008 - 19 cases (23% atypical / 77% without atypia); 2013 - 24 cases (42% atypical /58% without atypia) and 2018 - 31 cases (29% atypical /71% without atypia). Mean BMI was 35, 39 and 36 in 2008, 2013 and 2018 respectively. Age range 33 − 80 years. Mean age 2008 - 59; 2013 - 56; 2018 - 53. 74% (n=17) with atypical hyperplasia underwent hysterectomy. 26% (n=6) had medical treatment with levonorgestrel IUS or oral progestogens, and surveillance due to surgical unsuitability or patient choice. Hyperplasia without atypia was managed conservatively with progestogens and surveillance in 71% (n= 36) whilst 29% (n= 15) underwent
Study Objective: This study aimed to compare the survival outcomes of NACT followed by laparoscopic or open radical hysterectomy versus CCRT in patients with locally advanced cervical cancer. Design: Retrospective single-center study. Setting: Retrospective single-center study. Patients or Participants: Patients who were diagnosed as cervical cancer stage Ib1 to IVA at the Korea University Guro Hospital (February 2002» March 2014). Interventions: NACT followed by laparoscopic or open radical hysterectomy versus CCRT. Measurements and Main Results: Patients were categorized into two groups according to treatment method: NACT followed by laparoscopic and open radical hysterectomy with or without adjuvant chemotherapy (NCRH group) and concurrent chemoradiation (CCRT group). Survival outcomes and morbidity of the treatment were compared between the two groups using the Kaplan-Meier’s analysis. Conclusion: Neoadjuvant chemotherapy followed by laparoscopic and open radical hysterectomy seems to be a safe treatment option for locally advanced cervical cancer, in terms of similar survival outcomes and morbidity of treatment with CCRT. However, the present study is too limited to permit conclusions due to its small sample size and retrospective design despite statistical methods for adjusting confounding factors. Virtual Poster Session 4: Laparoscopy (1:40 PM — 1:50 PM) 1:40 PM: STATION E 1206 The Effect of Sub-Cutaneous and Intra-Peritoneal Anesthesia on Post Laparoscopic Pain: A Randomized Controlled Trial Gluck O,1,* Barber E,1 Feldstein O,1 Kerner R,1 Keidar R,1 Ginath S,1 Wolfson I,2 Bar J,1 Sagiv R1. 1Obstetrics and Gynecology, E. Wolfson Medical Center, Holon, Israel; 2Operation room, E. Wolfson Medical Center, Holon, Israel *Corresponding author. Study Objective: To evaluate whether sub-cutaneous (SC) trocar site and intra-peritoneal (IP) anesthesia reduce post-operative pain. Design: This is a randomized, controlled, double-blinded trial. The patients were randomly assigned to one of 4 groups: