The prognostic influence of hospital type, method of first histological confirmation and time to chemotherapy in patients with advanced primary ovarian cancer
There is a constant effort to improve the management of ovarian cancer. It is clear that the best chance of complete cure is at the time of the initial surgery. If the cancer can be completely cleared, survival is more likely.
Towards this end a proposed change in management has been developed, with a two-stage process, whereby an initial limited procedure is performed, to obtain a tissue biopsy, prior to complete clearance.
This review of 115 women with ovarian cancer, looks at whether there is any difference in outcome when the two-stage process is used. Also, the hospital type where the first procedure occurred may be significant, in that complete surgery at a centre of excellence has been shown to be advantageous for survival.
Results from the review showed no difference in overall survival, there was a delay in starting chemo for those having two-stage management. A surprising number of women, (10 out of 55 who had two-stage procedures), developed a metastasis at the entry port for the biopsy. Meaning that progression free survival was worse for them.
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