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Survival of patients with advanced ovarian cancer in a specialized center from 1998 – 2016
20 September 2018 (online)
Treatment of patients with ovarian cancer needs multiple skills and specialization. We report the outcome data from our learning curve and specialization process over the period when our team started in Wiesbaden 1999 then separating obstetrics and gynecology. There we started-with our ovarian cancer program. The next period from 2005 – 2010 covers the data after implementation of the quality assurance program. In 2011, we moved to Essen and further specialized by separating the breast unit from gynecologic oncology.
Descriptive analysis of all consecutive patients with primary diagnosis of advanced ovarian cancer (AOC) treated from 1998 – 2004, 2005 – 2010 and 2011 – 2016. All consecutively incoming patients were analyzed including those not fit enough for standard radical procedures.
The number of patients with AOC increased from 10 to 147 patients in 1998 to 2016, respectively. The rate FIGO IV disease increased from 27.6% to more than 50% in every year since 2013. The rate of complete resection was 50%, 67% and 69% in periods 1998 – 2004, 2005 – 2010, and 2011 – 2016, respectively. Correspondingly, median PFS increased from 19 to 22 and 28 months (p < 0.001); median OS increased from 34 to 46 and to 58 months, respectively (p = 0.001).
We demonstrate a correlation between specialization and improved outcome in AOC. Focusing and implementing a quality assurance program led to a significant improvement between the first and second period. However, an even more pronounced impact could be observed after additional structural changes by changing from a department of gynecology to a department of gynecologic oncology.