Surgery by gynecologic oncologist improves ovarian cancer survival

Ovarian cancer survival is improved when resection is performed by a gynecologic oncologist rather than by a general gynecologist. Moreover, a surgeon’s operative history alone had no effect on survival.

The results also indicate that gynecologic oncologists are more likely to follow surgical guidelines for cancer resection and are more likely to achieve complete tumor removal, according to according to the report in the February 1st issue of Cancer.The findings are based on a study of 512 women from the Netherlands who were diagnosed with epithelial ovarian cancer between 1994 and 1997. The subjects included 184 whose surgery was performed by a gynecologic oncologist and 328 who were operated on by a general gynecologist.Regardless of disease stage, 5-year survival was higher for patients treated by a gynecologic oncologist, senior author Dr. Ate G. J. van der Zee, from the University Medical Center Groningen, and colleagues note. In patients treated by gynecologic oncologists, 5-year survival rates for stage I-II and II-IV disease were 86% and 21%, respectively. The corresponding rates for patients treated by general gynecologists were significantly lower, at 70% and 13%.On multivariate analysis, surgery by a gynecologic oncologist reduced the risk of death by 21% overall and by 29% among patients younger than 75 years of age. As noted, gynecologic oncologists adhered to surgical guidelines more often than did general gynecologists. For example, in patients with stage I-II disease, 55% of gynecologic oncologists followed guidelines compared with 33% of general gynecologists (p = 0.01).With stage III disease, complete macroscopic tumor removal was achieved by gynecologic oncologists more often than by general gynecologists (p = 0.02).”Specific surgical training appeared to be important, because a surgeon’s patient volume alone had no effect on survival,” the authors point out. “These results imply that every patient who has suspected ovarian carcinoma deserves to undergo surgery performed by a gynecologic oncologist.”(Source: Cancer 2006;106:589-598: Reuters Health: Oncolink: February 2006.)