Introduction The aim of this study is to describe treatment and survival outcomes in patients with malignant ovarian germ cell tumors (MOGCT) who had surgery by general gynecologists (GG) versus gynecologic oncologists (GO).
Methods A population-based retrospective cohort study, including adult patients with MOGCT identified in the provincial cancer registry (1996–2020). Baseline characteristics, surgical and chemotherapy treatment were compared between those with surgery by GG or GO. Cox proportional hazards (CPH) model was used to determine if surgeon specialty was associated with overall survival (OS).
Results Overall, 363 patients were included. One-hundred and sixty (44%) patients underwent surgery by GO and 203 (56%) by GG. There were higher rates of stage II-IV in the GO group (27.5% vs 3.9%, p<0.001)(table 1). Multivariable logistic regression with age, histologic type, and socioeconomic status showed stage of disease was the only factor associated with having surgery by a GO (OR 6.79, 95% CI 2.83–16.30, p<0.001). 5-year OS was 90% vs 93% in the GO vs GG (p=0.39). CPH model showed factors associated with increased rate of death were age at diagnosis (HR 1.09, 95% CI 1.07–1.12) and chemotherapy (HR 3.12, 95% CI 1.44–6.75). Surgeon specialty was not independently associated with all-cause death (HR 1.04, 95% 0.51–2.15, p=0.91).
Conclusion/Implications In this group of MOGCT, the difference in 5-year OS was not statistically significant between patients having surgery by GO compared to GG, although survival rates were lower than expected in the GG group despite their low-risk features. Patients with confirmed/suspected MOGCT should be referred to GOs for optimal management.
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