Centralization of ovarian cancer surgery: do patients benefit?

Abstract

Background: The aim of the study was to compare the effect of surgery in patients with ovarian cancer by gynecologist-oncologists and general gynecologists on overall survival.

Material and methods: In a retrospective study all patients diagnosed with primary ovarian cancer at Vali-e-Asr Hospital (Tehran, Iran) between April 1999 and January 2005 were eligible for enrollment. A total 157 consecutive patients with ovarian cancer were available for analysis. There were no significant differences between the two groups with respect the stage, age and histological type of tumor. Of 157 patients, 60 were treated by gynecologist-oncologists and 95 by general gynecologists, and two patients were treated by general surgeons.

Results: The number of patients who had optimal cytoreductive surgery performed was higher in the gynecologist-oncologist group than the number in the general gynecologist group (p < 0.001). The majority of patients in the general gynecologist group needed a second operation while only a few in the gynecologist-oncologist group needed one (p < 0.001).The interval between initial surgery and beginning of chemotherapy was significantly longer in the gynecologist-oncologist group as compared to the general oncologist group (p = 0.001). Overall survival and disease-free survival were considerably better in the gynecologist-oncologist group but the difference was not significant.

Conclusion: Patients with ovarian cancer should be referred to Gynecology-Oncology Departments for optimal treatment.