Ovarian cancer staging: Does it require a gynecologic oncologist?

Mayer, Allan R.; Chambers, Setsuko K.; Graves, Ellen; Holm, Carole; Tseng, Paul C.; Nelson, Beth E.; Schwartz, Peter E.

doi:10.1016/0090-8258(92)90110-5

Cited by 139 publications

(77 citation statements)

References 13 publications

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“…The choice of physician can impact outcomes (130,131) as can adherence to the guidelines for the standard of care (132,133); surgery performed by a gynecologic oncologist results in superior outcomes and survival, compared with surgery performed by a non-gynecologic oncologist, such as a general surgeon. (Figure 4).…”

Section: [H1]managementmentioning

confidence: 99%

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Ovarian cancer

Matulonis

Sood

Fallowfield

et al. 2016

Nat Rev Dis Primers

894

787

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Ovarian cancer is not a single disease and can be subdivided into at least five different 2 histological subtypes that have different identifiable risk factors, cells of origin, molecular compositions, clinical features and treatments. Ovarian cancer is a global problem, is typically diagnosed at late stage, and has no effective screening strategy. Standard treatments for newly diagnosed cancer consist of cytoreductive surgery and platinum-based chemotherapy. In recurrent cancer, chemotherapy, anti-angiogenic agents, and poly (ADP ribose) polymerase (PARP) inhibitors are used and immunological therapies are currently being tested. High-grade serous carcinoma (HGSC) is the most commonly diagnosed form of ovarian cancer and is typically very responsive to platinum-based chemotherapy at diagnosis. However, in addition to the other histologies, HGSCs frequently relapse and become increasingly resistant to chemotherapy.Consequently, understanding the mechanisms underlying platinum resistance and finding ways to overcome them are active areas of study in ovarian cancer. Significant progress has been made in identifying genes associated with high risk of ovarian cancer (such as BRCA1 and BRCA2) as well as a precursor lesion of HGSC called a serous tubal intraepithelial carcinoma, which hold promise for identifying individuals at high risk of developing the disease and for developing prevention strategies. Competing interestsU.A.M. has served as a consultant for AstraZeneca, ImmunoGen, Pfizer, Genentech, and Merck.

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Section: [H1]managementmentioning

confidence: 99%

“…Surgical staging of ovarian cancer by gynaecological oncologists has been shown to be superior to that performed by non-oncological (general) surgeons as have patient outcomes (138)(139)(140).…”

Section: [H2] Precursor Lesionsmentioning

confidence: 99%

Ovarian cancer

Matulonis

Sood

Fallowfield

et al. 2016

Nat Rev Dis Primers

894

787

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“…[7][8][9] Comprehensive surgical evaluation of early-stage disease has been reported to be completed in the majority of patients (97%) by gynecologic oncologists, in half of the patients by gynecologists and in one-third of the patients by general surgeons. 10,11 Some of the studies 9,12 but not all 8,13 have shown a survival benefit if the patient has been operated by a gynecologic oncologist. Teaching hospitals have been reported to perform more accurate staging and gathering of data on tumor stage compared to non-teaching hospitals.…”

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confidence: 99%

Evidence of benefit from centralised treatment of ovarian cancer: A nationwide population‐based survival analysis in Finland

Kumpulainen

Grénman

Kyyrönen

et al. 2002

Intl Journal of Cancer

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To assess the effect of different hospital types or surgical volume on the survival of ovarian cancer patients, a nationwide and population-based analysis was carried out in Finland. The study included all 3,851 ovarian cancer patients operated from 1983-94. The patients were classified according to the hospital of the first surgery. The hospitals were categorized by type (university, central or other hospital) and, separately, into quartiles by the number of operated patients (surgical volume). The patients operated at university hospitals had better survival than those operated in central hospitals, the 5-year relative survival rates (RSR) being 45% (95% CI ‫؍‬ 42-48%) and 37% (34 -40%), respectively. RSR in the 'other hospital' category was 45% (42-48%). The RSR for the patients operated in the highest volume hospitals was 47% (43-50%), and by decreasing volume (quartile) the RSR was 40% (36 -43%), 40% (36 -43%) and 42% (38 -45%), respectively. After controlling for potential confounding by stage and age using regression models, the results remained practically the same. The results indicate that further centralizing of operative treatment of ovarian cancer may still improve survival rates on a population level in Finland. © 2002 Wiley-Liss, Inc. Key words: ovarian cancer; survival rates; operative treatment; centralized treatment; optimal care; cancer epidemiologyThe standard treatment of ovarian cancer is cytoreductive surgery followed by combination chemotherapy. Initial surgery is important for accurate staging of the disease and for removing as much of the tumor as possible. The initial operation has been suggested to provide the most important opportunity to affect survival. [1][2][3] Retrospective studies have shown that optimally debulked patients have better survival than suboptimally debulked patients. 1,[3][4][5][6] The highest rates of optimal cytoreduction have been reported to be achieved by gynecologic oncologists. [7][8][9] Comprehensive surgical evaluation of early-stage disease has been reported to be completed in the majority of patients (97%) by gynecologic oncologists, in half of the patients by gynecologists and in one-third of the patients by general surgeons. 10,11 Some of the studies 9,12 but not all 8,13 have shown a survival benefit if the patient has been operated by a gynecologic oncologist. Teaching hospitals have been reported to perform more accurate staging and gathering of data on tumor stage compared to non-teaching hospitals. 11,14 Ovarian cancer patients treated in teaching hospitals had better survival compared to non-teaching hospitals. 15 Cancer management by a multidisciplinary team improves the prognosis of ovarian cancer patients. 14,16,17 The Clinical Resource and Audit Group guideline states that patients who are suspected to have ovarian cancer should be referred in the first instance, either to a gynecological oncologist or to a gynecologist with a special interest in gynecological cancer. 18 Recommendations for centralization of ovarian cancer treatment have bee...

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“…Most studies confirm that in case the operation of ovarian cancer is done by a Gyneco-oncologist, the best survival shall be achieved (Eisenkop et al, 1992;Mayer et al, 1992;Le et al, 1997). On the one hand, adnexal mass patients' referral to Gyneco-oncologists might bring them stress of travel and difficulty fordoing follow-ups in relation with the operation.…”

Section: Introductionmentioning

confidence: 99%

Ovarian Malignancy Probability Score (OMPS) for Appropriate Referral of Adnexal Masses

Arab

Honarvar²,

Hosseini-Zijoud³

2014

Asian Pacific Journal of Cancer Prevention

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Background: Ovarian cancer is the most common cancer cause of gynecologic cancer deaths. In order to increase the likelihood of patient survival through primary operation by gyneco-oncologists, an appropriate algorithm for referral is considered here. Materials and Methods: Suspicious adnexal mass cases including ovarian malignancy probability score-1 (OMPS1) scores between 2.3-3.65 are re-evaluated by OMPS2. Sensitivity and specificity of each score were determined. Results: Sensitivity and specificity with a 3.82 score of OMPS2 in the studied subgroup (OMPS1 scores between 2.3-3.65) were 64% and 76.9% respectively. Conclusions: Management of OMPS1 scores of below 2.3 with sensitivity of 100% and above 3.65 with specificity of 72.9% is clear. In the subgroup of cases with OMPS1 score between 2.3-3.65, OMPS2 is helpful for triage with a cutoff score of 3.82.

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Ovarian cancer staging: Does it require a gynecologic oncologist?

Cited by 139 publications

References 13 publications

Ovarian cancer

Ovarian cancer

Evidence of benefit from centralised treatment of ovarian cancer: A nationwide population‐based survival analysis in Finland

Ovarian Malignancy Probability Score (OMPS) for Appropriate Referral of Adnexal Masses

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