Variation in gynecological oncology follow-up practice: Attributable to cancer centers or to patient characteristics? A Piedmont Regional Oncology Network Study

Luca Fuso, Andrea Evangelista, Eva Pagano, Elisa Piovano, Stefania Perotto, Simona Mazzola, Emiliana Bertoldo, Maria Rosa La Porta, Claudia Rosmino, Graziella Furbatto, Sergio Abate, Gianna Di Costanzo, Gianfranco Trossarelli, Maria Grazia Baù, Flavio Carnino, Giuseppina Gambaro, Paola Piantanida, Oscar Alabiso, Luciano Galletto, Laura ZavalloneAnnalisa Rossi, Maggiorino Barbero, Maria Tessa, Dionyssios Katsaros, Saverio Danese, Paola Brignolo, Gabriella Gorzegno, Raffaella Grillo, Giovanni Apolone, Giovannino Ciccone, Paolo Zola

Research output: Contribution to journalArticle

Abstract

Aims and background. Although guidelines recommend minimalist follow-up, there is wide variability in gynecological oncology practice. The aims of this study were to describe between-center differences in the follow-up of endometrial, ovarian, and uterine cervical cancer; to identify the determinants of test prescription; to estimate the related costs; and to assess the weight of center habits and patient characteristics as sources of unexplained variability. Methods and study design. The medical records of patients treated between August 2004 and July 2005 for gynecological malignancies and followed up for the detection of recurrent disease were retrospectively collected from 29 centers of the Piedmont Oncology Network. Multivariate multilevel analyses were performed to study the determinants of test prescription and costs. Results. Analyses were performed on 351 patients (median follow-up: 578 days). The unexplained variability in computed tomography prescriptions (26%), ultrasound prescriptions (17%), and total cost of follow-up (15%) can be attributed to center habits, independenty of the clinical characteristics of the patients. Conclusions. Much of the unexplained variability in the follow-up for gynecological malignancies is attributable to different habits of centers belonging to a cancer network. These results prompted us to design a multicenter randomized controlled trial to compare minimalist versus intensive follow-up programs in endometrial cancer.

Original languageEnglish
Pages (from-to)551-558
Number of pages8
JournalTumori
Volume97
Issue number5
Publication statusPublished - Sep 2011

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Keywords

  • Appropriateness
  • Evidence- based medicine
  • Follow-up
  • Gynecological cancer

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Fuso, L., Evangelista, A., Pagano, E., Piovano, E., Perotto, S., Mazzola, S., Bertoldo, E., La Porta, M. R., Rosmino, C., Furbatto, G., Abate, S., Di Costanzo, G., Trossarelli, G., Baù, M. G., Carnino, F., Gambaro, G., Piantanida, P., Alabiso, O., Galletto, L., ... Zola, P. (2011). Variation in gynecological oncology follow-up practice: Attributable to cancer centers or to patient characteristics? A Piedmont Regional Oncology Network Study. Tumori, 97(5), 551-558.