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abstract
Objective: Early involvement of
specialists is associated with improved survival in ovarian cancer
patients. However, only 33-60% of patients are currently being referred.
A more effective strategy to get patients with an elevated risk of
ovarian cancer to gynecologic oncologists is needed. The objective of
this study was to evaluate the clinical utility of a multivariate index
assay, OVA1, by assessing its ability to drive referral of ovarian
cancer patients to gynecologic oncologists prior to their first surgical
intervention.
Research design and methods:
Information on patients who received an OVA1 test was collected
retrospectively from 22 obstetricians/gynecologists through a chart
review. Physicians were recruited from a variety of practices and
hospitals representing major geographic regions within the United
States. Clinical utility of OVA1 was assessed by examining the rate at
which obstetricians/gynecologists involved a gynecologic oncologist for
patients with elevated-risk OVA1 results prior to first surgical
intervention.
Results: A total of 136
patients with elevated-risk OVA1 results were assessed, of which 122
underwent surgery to remove an adnexal mass. Prior to surgery, 98 (80%)
of the patients were referred to a gynecologic oncologist with an
additional 11 (9%) having a gynecologic oncologist available if required
by intra-operative findings. Primary ovarian cancer was found in 65
(53%) patients, and gynecologic oncologists performed 61 (94%) of the
initial surgeries these patients. Similar results were found in
premenopausal and postmenopausal patients.
Conclusions:
A high proportion of patients with an elevated-risk OVA1 results were
referred to a gynecologic oncologist prior to their initial surgery.
Nearly all of the patients who had primary ovarian malignancies were
appropriately referred to gynecologic oncologists, highlighting the
clinical utility of OVA1. Nearly all patients identified with ovarian
cancer received their initial surgery by a gynecologic oncologist -
demonstrating a higher rate of gynecologic oncologist involvement in
comparison to past studies. The study may be limited by unintentional
bias in physician response and recall.
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