Impact of chemotherapy provider specialty on outcomes in ovarian cancer

Abstract

Objectives: Gynecologic oncologist (GO) surgeons are associated with improved outcomes for ovarian cancer (OC) patients, but evidence is limited for GOs as chemotherapy providers. We evaluated the impact of different chemotherapy provider specialties on survival in epithelial OC.

Methods: In this retrospective cohort study from January 2015 to December 2021 at an academic medical institution, we classified chemotherapy provider type into three groups: A) exclusively GO (all chemotherapy provided by a GO); B) shared model (chemotherapy provided by both a GO and a medical oncologist); and C) primarily non-GO (chemotherapy provided by a medical oncologist and a GO was only involved at times of disease progression or less frequently). Primary outcomes were overall survival (OS) and progression-free survival (PFS).

Results: Of 319 patients, 162 (50.8 %) were classified into chemotherapy provider type group A, 116 (36.4 %) into group B, and 41 (12.9 %) into group C. Provider group patient populations varied by demographic and clinical characteristics. Older age and increased distance to a GO were associated with decreased odds of GO chemotherapy involvement. Chemotherapy provider group was not significantly associated with OS (group B: HR 0.94 95 % CI 0.57-1.57, group C: HR 1.75 95 % CI 0.92-3.33) or PFS (group B: HR 1.20 95 % CI 0.84-1.71, group C: HR 1.36 95 % CI 0.83-2.21).

Conclusions: There was no survival difference across the three designated chemotherapy provider groups. Shared chemotherapy responsibility may be a reasonable care model, especially for patients with difficulty accessing GO care. Responsibility sharing between GOs and medical oncologists is heterogenous and requires further characterization.

Keywords: Chemotherapy provider; Geographic disparity; Medical oncologist; Ovarian cancer; Rural access; Survival.