Cancer Surgery in Ontario, Chapter 7, Surgery for Ovarian Cancer 2008 December report

Cancer Surgery in Ontario, Chapter 7, Surgery for Ovarian Cancer.pdf (application/pdf Object)

Implications:

 More research is needed to better
understand why the use of cancer
staging procedures—such as
omentectomy and lymph node
excision—varied among women in
the study cohort who underwent
surgery for ovarian cancer.

 Plans for expanding surgical services
related to the treatment of ovarian
cancer in Ontario should factor in the
existing referral patterns among Local
Health Integration Networks (LHINs).

 There are relatively few gynecologic
oncologists in Ontario; these subspecialists
provide care to a large
number of women with ovarian cancer.
Further evaluation is required—both
in terms of the role of gynecologic
oncologists in treating women with
ovarian cancer, and also whether the
supply of these specialists will be
sufficient to meet future demand.

Findings

• While the incidence of ovarian cancer among Ontario women increased with age in 2003/04, the probability of surgical treatment decreased. About three-quarters (73 percent) of women in the Overall Ovarian Cancer Cohort underwent a surgical procedure related to the diagnosis and treatment of their disease.

• There was no clear relationship between women’s socioeconomic status and whether they had surgery for ovarian cancer. However, those living in regions with the lowest neighbourhood income were less likely than all others to have ovarian cancer-related surgery. (duh?)


• Rates of ovarian cancer-related surgery ranged across Local Health Integration Networks (LHINs) of patient residence—from a low of 58 percent among women living in the North West LHIN to a high of 88 percent among those residing in the Erie St. Clair LHIN.

Lymph node excision was done in just eight percent of women with ovarian cancer


During the study period, gynecologic oncologists comprised about seven percent of all physicians performing ovarian cancer
surgery in Ontario. Yet these sub-specialists performed nearly half (49) percent of all the surgeries among women in the
Ovarian Cancer Surgery Cohort.

Obstetrician/gynecologists performed 40 percent of surgeries on women in this study cohort; the remaining 12 percent of
procedures were done by physicians with other specialties.

Gynecologic oncologists were more likely than obstetrician/gynecologists to perform omentectomy (70 percent vs. 44 percent respectively) and lymph node excision (13 percent vs. six percent