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Abstract
Introduction/Background It is well known that ovarian cancer survival depends on complete cytoreduction. Patients treated in high volume hospitals by specialized gynecologic oncologists have better surgical outcomes. In order to maximize survival rates, implementation of centralization of services for patients with ovarian cancer has been done. However, there are some studies which show that centralization has not proven to be synonymous with improved outcomes, especially when it induces delay in treatment.
Methodology This was a retrospective observational study based on all ovarian cancer patients diagnosed in our hospital since 2016.
We measured the waiting time for therapy after diagnosis in our hospital and after referral to treatment to high volume hospital. We also compared outcomes in both groups.
Results Eighty three ovarian cancers were diagnosed between 2016 and 2023 in our hospital. 39 were treated in our hospital (2016–2019) and 44 were sent to a high volume hospital (2019–2023). Median treatment intervals were increased from 19.9 to 37.5 days (p0.01) since implementation of centralization. The major cause of the delay in high volume hospital was the use of positron emission tomography in 52% of cases before treatment. Treatment was modified by PET result only in 11.3% of cases. 11.3% of patients who were treated by the high-volumen were better debulked; all these patients underwent III-IV ovarian cancer FIGO stages. Same number of complications were detected. By the date, any changes in survival were found.
Conclusion Lower ovarian cancer stages (I-II) are not better treated by centralized care in hig-volumen hospitals since it causes a delay on treatment and it doesn’t modify the results.
Centralization improves debulking rates in IIB-IV ovarian FIGO stages.
More research is needed to evaluate the improvement of overall survival rates in advanced ovarian cancer.
Patients may benefit from an integrated and coordinated management to allow advantages from both hospitals
Disclosures Nothing to disclose.
