Introduction/Background Predicting whether an ovarian tumour (OT) is malignant remains a challenge. Risk assessment strategies are used to select which patients with an OT should be referred to oncologic centres. However, their predictive value depends on the prevalence within a population. On hospital level, this prevalence is often known, but on a national level, these data are more difficult to obtain. Significant differences in prevalence exist between individual hospitals and single-centre study results should be generalised with caution. Therefore, we aimed to evaluate the prevalence of malignancy among surgically removed OTs and the accuracy of referral to oncologic centres in the Netherlands.
Methodology Histological reports on surgically removed OTs in 2019 were retrieved from the Dutch Pathology Registry PALGA (Pathologic-Anatomic National Computerized Archive). Reports on prophylactic removed ovaries, recurrent ovarian cancer (OC) and reports of patients below 18 years were excluded. Data on stage, subtype and surgical procedure of malignant and borderline OTs from the same year were obtained from the Dutch Gynaecological Oncology Audit (DGOA).
Results A total of 17469 reports were retrieved from PALGA of which 6122 reports were eligible, including 4867 benign (79.5%), 870 malignant (14.3%) and 385 borderline OTs (BOT, 6.3%). From DGOA, 1344 reports were retrieved. Referral for cytoreductive surgery for advanced OC was 100%. Early-stage OC and BOTs were also mainly operated in oncological centres and 66 OCs were operated in non-oncologic centres (figure 1).
Conclusion Correct classification of OTs is crucial for treatment planning, patients’ well-being and optimal use of health care resources. In the Netherlands, the majority of patients with early-stage OC are correctly referred. Because only 66 OCs were missed out of a total group of 6122 OTs, current risk assessment strategies generally selected the correct patients for referral. However, there is still room to improve preoperative risk assessment.
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