Abstract
BACKGROUND:
Better
outcome of advanced ovarian cancer after centralized surgery has led to
the recommendation for centralized surgery in a Norwegian health
region. Whether the practice pattern has changed according to this
recommendation has not been examined.
OBJECTIVE:
The
objective of this study was to evaluate the referral practice and
treatment of ovarian cancer in a Norwegian health region after the
introduction of centralized surgery.
METHODS:
This was a
retrospective, population-based study, including all women undergoing
surgery for primary ovarian, tubal, and peritoneal cancer between 2000
and 2005, in Health Region IV of Norway. Clinical data and data
regarding treatment and 5-year follow-up were analyzed.
RESULTS:
In
total, 279 cases of ovarian, peritoneal, and tubal cancer were
included. Eighty-four percent underwent primary surgery at the teaching
hospital and 16% at the nonteaching hospitals. After an immediate rise
in the number of cases undergoing primary surgery at the teaching
hospital after the introduction of centralization in 1995, the
percentage distribution between the teaching and nonteaching hospitals
was stable during the study period. The women who underwent surgery at
the nonteaching hospitals had a higher percentage of early-stage disease
and were at higher risk of reoperation for comprehensive staging.
CONCLUSIONS:
Centralization
of ovarian cancer surgery has been successfully accomplished in a
health region in Norway. The referral practice of assumed advanced
ovarian cancer cases shows satisfactory compliance with centralization
at 10 years after the implementation of centralized surgery.
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