Women are 30 percent less likely to die of ovarian cancer if they have guideline-recommended treatment, yet nearly two-thirds of those with the disease do not receive it, often because they are cared for at hospitals that treat a small number of ovarian cancer patients. These are the findings of a study of more than 13,000 patients being presented at the Society of Gynecologic Oncology (SGO) Annual Meeting on Women's Cancer in Los Angeles, March 9-12.
Women with ovarian cancer treated by high-volume surgeons and at high-volume hospitals were more likely to receive therapy recommended by the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines, according to the study. A high-volume surgeon is one who treats 10 or more ovarian cancer patients a year; a high volume hospital treats 20 or more per year. More than 15,000 women die of ovarian cancer each year, making it the fifth leading cause of death among American women.
"There may be a number of reasons women do not receive guideline-adherent care, such as that low-volume hospitals may not have access to gynecologic oncologists who specialize in this care," said Robert E. Bristow, MD, Director of the Division of Gynecologic Oncology at the University of California, Irvine Medical Center. "Patients need to be their own advocates and ask the provider and hospital how many ovarian cancer patients they treat, how many ovarian cancer surgeries they perform and their ovarian cancer patients' rates of survival. If a surgeon only performs two ovarian cancer surgeries a year, you don't want to be one of those two."
The study was an analysis of treatment of 13,321 ovarian cancer patients reported to the California Cancer Registry from 1999 through 2006. NCCN guideline-adherent care includes a combination of surgery and chemotherapy depending on the stage of the cancer. Only 4,952 patients (37 percent) received care recommended by NCCN guidelines, researchers found. Patients who did not receive guideline-adherent care were 30 percent more likely to die of ovarian cancer during the five-year follow-up period.
The study is the first large-scale population-based analysis to validate the NCCN treatment recommendations, showing that they correlate with improved clinical outcomes, said Dr. Bristow. NCCN is a not-for-profit alliance of 21 of the world's leading cancer centers that work together to develop guidelines for most cancers.