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Therapy of ovarian cancer (OC) in Germany – Treatment characteristics and survival results of the QS OVAR 2012
20 September 2018 (online)
Quality of treatment in patients with OC is one of the main prognostic factors. The Qualitätssicherung Ovar (QS Ovar) was implemented as a nationwide initiative in 2000 in Germany and repeated about every 4 years.
All hospitals in Germany were asked to document their patients anonymously with first diagnosis of OC in Q3/2012.
267 hospitals documented 940 pts (> 60% of all pts in Germany). Surgical staging according to guidelines was done in 69.6% of patients with early OC (FIGO I-IIA). There was a significant improvement (p < 0.001) compared to earlier years (e.g. 38.8% in 2004). Missing procedures were e.g. peritoneal biopsies (27.1%) and para-aortic lymphadenectomy (25.2%). 78.5% received the standard chemotherapy. 4 year overall survival (OS) in patients with standard therapy was 92.0% vs. 78.5% in patients not treated according to guidelines (p = 0.003). 77.2% were diagnosed at advanced FIGO stage IIB-IV. The rate of complete resection was 44.5%, which has also improved compared to earlier years (p = 0.004). 90.8% of the patients treated with chemotherapy received the recommended standard of at least carboplatin and paclitaxel. The 4 year OS rate of patients with complete resection and standard chemotherapy was 63.4% compared to 34.6% in patients with only one optimal treatment modality and 4.9% in patients with incomplete resection and a nonstandard systemic therapy (p < 0.001).
The quality of treatment has improved. It shows a significant impact on further prognosis. Therefore, our aim should be the further improvement of surgical and medical treatment in Gynecologic Departments.