Objectives. Objectives of this study were to evaluate the effect of changes in patterns of care, for example centralization and treatment sequence, on surgical outcome and survival in patients with epithelial ovarian cancer (EOC).
Methods. Patients diagnosed with FIGO stage IIB-IV EOC (2004-2013) were selected from the Netherlands Cancer Registry. Primary outcomes were surgical outcome (extent of macroscopic residual tumor after surgery) and overall survival. Changes in treatment sequence (primary debulking surgery and adjuvant chemotherapy (PDS + ACT) or neo-adjuvant chemotherapy and interval debulking surgery (NACT + IDS)), hospital type and annual hospital volume were also evaluated.
Results. Patient and tumor characteristics of 7987 patients were retrieved. Most patients were diagnosed with stage HI-IV EOC. The average annual case-load per hospital increased from 8 to 28. More patients received an optimal cytoreduction (tumor residue = 20 cytoreductive surgeries annually), 80% in medium (10-19 surgeries) and 71% in small hospitals (
Conclusion. Changes in pattern of care for patients with EOC in the Netherlands have led to improvement in surgical outcome and survival. (C) 2016 Elsevier Inc. All rights reserved.