An italian national survey on ovarian cancer treatment at first diagnosis. There's none so deaf as those who will not hear

Vincenzo Dario Mandato, Federica Torricelli, Stefano Uccella, Debora Pirillo, Gino Ciarlini, Gabriele Ruffo, Gianluca Annunziata, Gloria Manzotti, Sandro Pignata, Lorenzo Aguzzoli

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Epithelial ovarian cancer (EOC) is the most lethal gynecological malignancy, crucial prognostic factors are no gross residual disease and centralization of cases. To evaluate the centralization of EOC patients, we report the results of a survey that shows the daily management of EOC patients in Italy. Methods: A 49-items electronic unblinded survey assessing demographics, practice characteristics, current opinions and approach to managing advanced EOC at first diagnosis was sent both to general gynecologists (GG) and gynecologic oncologists (GO). Differences in frequency distribution of answers between gynecologists with different expertise were evaluated using Fisher exact test. Multivariable analyses were performed applying generalized linear models. Results: 84/192 (44%) GG and 108/192 (56%) GO from all Italian regions answered to our survey. GOs declared to perform fertility sparing surgery in early EOC more frequently than GG (p=0.002). GOs can perform a frozen section and have both a gynecopathologist and a dedicated general surgeon. 89% of GOs consider as "optimal debulking" no gross residual disease and 81% achieve this at upfront cytoreduction in more than 40% of patients. Use of neoadjuvant chemotherapy decreases in higher volume centers (p≤0.001) while it is lower in the group of GOs than in the GGs group (p0.001). Conclusions: EOC patients are still treated by GGs. GOs perform more upfront surgery and achieve optimal debulking in a greater percentage of patients than GGs. In Italy an adequate centralization of cases has not yet been achieved, and this may have detrimental effects on the quality of treatment.

Original languageEnglish
Pages (from-to)4443-4454
Number of pages12
JournalJournal of Cancer
Volume12
Issue number15
DOIs
Publication statusPublished - 2021

Keywords

  • Centralization
  • Cytoreduction
  • Epithelial Ovarian Cancer
  • Gynecologic Oncologists
  • Survey

ASJC Scopus subject areas

  • Oncology

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