Studies examine associations between provider characteristics and mortality rates in ovar...( rs with different caseloads. The strong...)

Studies examine associations between provider characteristics and mortality rates in ovarian cancer

rs with different caseloads. The strong association between high case volume and favorable outcomes seen in studies of high risk operations such as pancreatetomy, esophagectomy and lung resections was not found in this study of ovarian cancer surgery, the authors conclude.

"Although chronologic age and clinical stage dwarfed both hospital and procedure volume as factors associated with outcomes of care, even the modest volume-outcome variations we observed merit further scrutiny to understand the underlying mechanisms that enable higher-volume hospitals and surgeons to achieve more favorable surgical outcomes," the authors write.

In addition to hospital or surgeon volume, a surgeon's area of specialty may also affect patient outcomes. Previous studies have found that patients are more likely to receive the recommended surgery and treatment for ovarian cancer if they are treated by highly specialized surgeons such as gynecologic oncologists. To examine the association between surgeon specialty and patient outcome, Craig C. Earle, M.D., of the Dana-Farber Cancer Institute in Boston, and colleagues identified 3067 ovarian cancer patients in the SEER database who underwent a surgical procedure to remove ovarian cancer.

Of those patients, 33% were treated by a gynecologic oncologist, 45% by a general gynecologist, and 22% by a general surgeon. Ovarian cancer patients treated by gynecologic oncologists had the best outcomes and lowest mortality rates after surgery. Outcomes among these patients were marginally superior to those of patients treated by general oncologists, and much better than those of patients treated by general surgeons. Gynecologic oncologists were most likely to perform sufficiently extensive surgery, and were most likely to provide patients with post-operative chemotherapy when needed.

"Our data support professional societies' recommendations that it is preferable for ovarian cancer patients to be operated on by gyneco
'"/>

Contact: Ariel Whitworth
jncimedia@oxfordjournals.org
301-841-1287
Journal of the National Cancer Institute
31-Jan-2006

Page: 1 2 3
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