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What changes in the organisation of cancer services will improve the outcome for women with ovarian cancer?
Article first published online: 19 AUG 2005
DOI: 10.1111/j.1471-0528.1997.tb11032.x
Issue
1471-0528/asset/cover.gif?v=1&s=b4e1d96c46e18c61210d584b63c13ee375cf562b "BJOG: An International Journal of Obstetrics & Gynaecology")
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 104, Issue 2, pages 135–139, February 1997
Additional Information
How to Cite
Woodman, C., Baghdady, A., Collins, S. and Clyma, J.-A. (1997), What changes in the organisation of cancer services will improve the outcome for women with ovarian cancer?. BJOG: An International Journal of Obstetrics & Gynaecology, 104: 135–139. doi: 10.1111/j.1471-0528.1997.tb11032.x
Publication History
- Issue published online: 19 AUG 2005
- Article first published online: 19 AUG 2005
- Received 29 January 1996 Accepted 26 July 1996
- Abstract
- Article
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Objective To examine the influence of operator specialty, volume of work and referral to an oncologist on the survival of women with ovarian cancer.
Design Population-based retrospective cohort study, using hospital records and Cancer Registry data.
Setting The North Western Region, UK.
Population Six hundred and ninety-one women undergoing laparotomy for histologically confirmed ovarian malignancy during 1991 to 1992.
Methods Univariate and multivariate survival analyses.
Main outcome measures Univariate survival estimates. Relative risks, derived from Cox's proportional hazards model, describing the effect on survival of surgeons vs gynaecologists as baseline, high volume vs low volume operators and referral vs nonreferral to an oncologist.
Results After adjusting for woman and disease-related prognostic factors, operation by a surgeon was shown to have an adverse impact on survival (RR = 1.58, 95% CI 1.19 to 2.10). Regardless of how a high volume operator was defined (in terms of the number of laparotomies performed), no survival advantage over low volume operators could be demonstrated. Women referred to an oncologist had significantly better survival than women not referred (RR = 0.54, 95% CI 0.43 to 0.68)
Conclusions All women undergoing surgery for ovarian cancer should have access to a gynaecological opinion and postoperatively should be referred for a nonsurgical oncological opinion.