Studies examine associations between provider characteristics and mortality rates in ovar...( Two studies in the February 1 issue of ...)

Past studies have suggested that patients treated at hospitals with higher case loads or by more experienced surgeons have higher survival rates after surgery for certain types of cancer, including colorectal cancer and lung cancer. Patients may take such factors into account when making decisions about where and from whom to seek medical care.

Ovarian cancer ranks fourth in cancer death in U.S. women and was expected to have claimed more than 16,000 lives in 2004. It is typically a disease of women in their sixth or seventh decade. To examine the association between hospital case volume and procedure-specific experience of surgeons on outcomes after ovarian cancer surgery, Deborah Schrag, M.D., of the Memorial-Sloan Kettering Cancer Center in New York City, and colleagues used the Surveillance, Epidemiology, and End Results (SEER)Medicare linked database to identify 2952 patients age 65 or older who had surgery for primary ovarian cancer between 1992 and 1999. They looked at both short-term (60-day) and longer term (2-year) mortality rates and overall survival.

The authors found that hospital case load and surgeon-specific experience were not associated with short term mortality following ovarian cancer surgery after adjustment for variation in patient clinical characteristics. They did find that longer term outcomes were somewhat more favorable for patients treated at high-volume hospitals compared with those treated at low-volume hospitals, but this difference was not of large magnitude. The magnitude of these associations was modest when the authors took into account the variation in clinical stage at diagnosis, age, and other factors among patients treated by provide
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Contact: Ariel Whitworth
jncimedia@oxfordjournals.org
301-841-1287
Journal of the National Cancer Institute
31-Jan-2006