Hospital Case Load May Affect Survival in Ovarian Cancer
Posted: Friday, June 19, 2020
Previous studies have proposed that performing a minimum of 20 surgical cases per hospital should be considered the standard of care for ovarian cancer; however, a recent study has reported that a higher minimum may be needed to improve patient survival. Anna Jo Bodurtha Smith, MD, of the Johns Hopkins School of Medicine, Baltimore, and colleagues found that high-volume hospitals treating more than 100 ovarian cancer cases annually have the best outcomes. These findings were made available as part of the virtual platform of the 2020 Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer (Abstract 154).
Researchers used the National Cancer Database to perform a retrospective cohort analysis of women who were diagnosed with stage II to IV ovarian cancer between 2004 and 2015. Hospitals were analyzed based on their annual overall volume and cytoreductive surgical volume.
There were 96,521 women identified from 1,325 hospitals, with an overall annual hospital volume of 42. Nearly 25% of hospitals cared for fewer than 16 women a year. The survival was lowest among hospitals treating fewer than 20 patients with ovarian cancer a year (hazard ratio = 1.07) and was significantly improved among hospitals treating more than 140 patients with ovarian cancer (hazard ratio = 0.74). There was a 5-month difference in mean survival between hospitals that cared for 20 patients compared with those caring for more than 20 patients.
In addition, approximately 25% of hospitals performed fewer than 21 cytoreductive surgeries per year, with a mean of 45. Patients treated at hospitals performing fewer than 20 of these procedures had a worse outcome (hazard ratio = 1.06) than those treated at hospitals performing more than 140 procedures (hazard ratio = 0.72). A 3-month survival difference was observed when comparing hospitals performing fewer than 20 cytoreductive surgeries with those performing more, and a 6-month difference in survival was seen between hospitals performing fewer than 20 surgeries compared with those performing more than 100 surgeries.
Disclosure: The study authors’ disclosure information can be found at sgo.confex.com.