Ovarian cancer survival influenced by MD specialty

The survival rate of women with ovarian cancer is improved when surgery is performed by a gynecologic oncologist rather than by a general gynecologist, according to the findings of a new study.

The results also indicate that gynecologic cancer specialists (oncologist) are more likely to follow surgical guidelines for cancer surgery and are more likely to completely remove the tumor.

The findings are based on a study of 512 women from the Netherlands who were diagnosed with ovarian cancer between 1994 and 1997. The subjects included 184 whose surgery was performed by a gynecologic oncologist and 328 who were operated on by a general gynecologist.

The five-year survival rate was higher for patients treated by a gynecologic oncologist, senior author Dr. Ate G. J. van der Zee, from the University Medical Center Groningen, and colleagues note.

In patients treated by gynecologic oncologists, 5-year survival rates for less advanced cancers was 86 percent and for more advanced cancers was 21 percent. The corresponding rates for patients treated by general gynecologists were significantly lower, at 70 percent and 13 percent.

When other factors that can influence patient outcome were considered, researchers found that the overall risk of death was reduced by 21 percent and the risk of death among patients younger than 75 years of age was reduced by 29 percent if a gynecologic oncologist performed the surgery.

As noted, gynecologic oncologists adhered to surgical guidelines more often than did general gynecologists. For example, in patients with stage I-II disease, 55 percent of gynecologic oncologists followed guidelines compared with 33 percent of general gynecologists.

In patients with stage III disease, complete tumor removal was achieved by gynecologic oncologists more often than by general gynecologists.

"Specific surgical training appeared to be important, because a surgeon's patient volume alone had no effect on survival," the authors point out in the medical journal Cancer.

"These results imply that every patient who has suspected ovarian carcinoma deserves to undergo surgery performed by a gynecologic oncologist," the authors conclude.

SOURCE: Cancer, February 1, 2006.