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. 2014 May;133(2):142-6.
doi: 10.1016/j.ygyno.2014.02.006. Epub 2014 Feb 8.

Reasons for failure to deliver National Comprehensive Cancer Network (NCCN)-adherent care in the treatment of epithelial ovarian cancer at an NCCN cancer center

Britt K Erickson  1 , Jovana Y Martin  2 , Monjri M Shah  3 , J Michael Straughn Jr  3 , Charles A Leath 3rd  3
Affiliations

Reasons for failure to deliver National Comprehensive Cancer Network (NCCN)-adherent care in the treatment of epithelial ovarian cancer at an NCCN cancer center

Britt K Erickson et al. Gynecol Oncol. 2014 May.

Abstract

Objective: The National Comprehensive Cancer Network (NCCN) has established guidelines for treating epithelial ovarian cancer (EOC) which includes cytoreductive surgery and platinum and taxane-based chemotherapy (CT). The objective of this study was to determine the reasons for failure to deliver NCCN-adherent care at an NCCN cancer center serving a diverse racial and socioeconomic population.

Methods: Medical records of women with EOC diagnosed between 2004 and 2009 were reviewed for demographic, clinical, tumor, treatment, and survival data. Independent reviewers determined if their treatment met criteria for being NCCN-adherent. Progression-free survival (PFS) and overall survival (OS) were calculated with Kaplan-Meier estimates and compared with the log-rank test.

Results: 367 patients were identified. 79 (21.5%) did not receive NCCN-adherent care. Non-adherent CT in 75 patients was the most common reason for failure to receive NCCN-adherent care. 39 patients did not complete CT due to treatment toxicities or disease progression. 12 patients received single agent CT only and 4 received no CT due to comorbidities. 2 patients declined CT. 18 patients died in the postoperative period without receiving CT. 8 patients did not undergo cytoreduction due to disease progression or comorbidities. PFS and OS were improved in the NCCN-adherent cohort (PFS: 5.7 vs. 18.3 months, p<.005) (OS: 11.4 vs. 49.5 months, p<.005).

Conclusions: The vast majority of patients at an NCCN cancer center received NCCN-adherent treatment. Reasons for failure to receive NCCN-adherent care were variable, but most did not receive chemotherapy in accordance with guidelines due to comorbidities or disease progression.

Keywords: Epithelial ovarian cancer; NCCN-adherent care; Treatment disparities.

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Conflict of interest statement

Disclosure: The authors declare there are no conflicts of interests.

Figures

Figure 1:
Figure 1:
Progression-free survival based on receipt of NCCN-adherent care
Figure 2:
Figure 2:
Overall survival based on receipt of NCCN-adherent care
See this image and copyright information in PMC

Comment in

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