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Practice patterns in post-treatment surveillance in patients with primary epithelial ovarian cancer
  1. Joseph DeMari1,
  2. Monica Hagan Vetter1,
  3. Shruthi Chandra2,
  4. John L Hays3 and
  5. Ritu Salani1
  1. 1Department of Obstetrics and Gynecology, The Ohio State University Medical Center, Columbus, Ohio, USA
  2. 2The Ohio State University College of Medicine, Columbus, Ohio, USA
  3. 3Department of Internal Medicine, The Ohio State University Medical Center, Columbus, Ohio, USA
  1. Correspondence to Dr Joseph DeMari, Department of Obstetrics and Gynecology, The Ohio State University Medical Center, Columbus, OH 43210, USA; joseph.demari{at}osumc.edu

Abstract

Background The Society of Gynecologic Oncology created guidelines to standardize cost-effective clinical surveillance for detection of recurrence of gynecologic cancers.

Objective To determine practice patterns for surveillance of primary ovarian cancer after complete response to therapy and to identify the percentage of clinicians who follow the surveillance guidelines endorsed by the Society of Gynecologic Oncology.

Methods A single-institution retrospective cohort study was conducted including patients with epithelial ovarian cancer with a complete response to primary therapy between January 2012 and December 2016. Patients were excluded if they were participating in clinical trials that required routine imaging. Data on surveillance and recurrence were collected. Descriptive statistics as well as Fisher’s exact test and chi-square test were performed due to the exploratory nature of the study.

Results A total of 184 patients met the inclusion criteria. Median follow-up for the cohort was 37 months (range 6–80). Surveillance was completed in compliance with Society of Gynecologic Oncology guidelines in 78% of patients. Of 39 visits that were non-compliant, 44% (17) were patient initiated (scheduling conflict, missed appointment), 15% (6) were due to the provider intentionally scheduling alternative follow-up, while 41% (16) were off schedule due to problem visits (patient complaint of symptoms). Patients with early-stage cancers were more likely than advanced-stage patients to be non-compliant (33% vs 15%, p=0.006). Patients with non-serous histologies had a higher frequency of non-compliance (31% vs 16%, p=0.035). When stratified by early versus advanced stage, there was no difference in progression-free survival or overall survival based on compliance.

Conclusions Overall, there was a relatively high rate of compliance with Society of Gynecologic Oncology surveillance guidelines for patients with epithelial ovarian cancer. Patients with non-serous histologies and patients with early-stage disease had a higher rate of non-compliance, and these patients may represent special groups that would benefit from additional survivorship education.

  • ovarian cancer
  • neoplasm recurrence, local
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Footnotes

  • Presented at This paper expands upon the work presented as a poster at the 2019 International Gynecologic Cancer Society meeting.

  • Contributors All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by JD, SC, and MHV. The first draft of the manuscript was written by JD. Manuscript review and editing were performed by JD, MHV, JH, and RS. Supervision of the study was conducted by RS.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. De-identified participant data are available from Dr Joseph DeMari, ORCID 0000-0003-2373-9687, upon reasonable request.

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