Many Ovarian Cancer Patients Denied By-the-Book Care, Study Says

Result: They're 30 percent more likely to die over five-year span, researchers find

By Kathleen Doheny
HealthDay Reporter

MONDAY, March 11 (HealthDay News) -- Nearly two-thirds of ovarian cancer patients don't receive recommended treatment that could extend their lives, U.S. researchers have found.

For patients who didn't get care that follows the National Comprehensive Cancer Network (NCCN) clinical practice guidelines, the risk of dying within five years of follow-up was 30 percent greater compared to women who got recommended treatment, said researcher Dr. Robert Bristow, director of gynecologic oncology at the School of Medicine of the University of California, Irvine.

Low-volume hospitals -- those that treat few cases of ovarian cancer -- are less likely than larger hospitals to follow the established recommendations for ovarian cancer, according to the study.

The findings lend support to the guidelines, Bristow said.

Women facing treatment for ovarian cancer, he said, should ask their doctor: "How many ovarian cancer patients do you treat a year?" If the answer is two, "You probably don't want to be one of those patients," Bristow said.

Each year, about 22,000 new cases of ovarian cancer are diagnosed in the United States, and more than 15,000 women die of it, according to the American Cancer Society.

For the study, Bristow and his colleagues analyzed the treatment and results for more than 13,000 women with ovarian cancer, using data reported to the California Cancer Registry from 1999 through 2006.

That time period was selected because there was no overall change in treatment approaches during those years, Bristow said. Such changes might have affected the results, scheduled for presentation Monday at the Society of Gynecologic Oncology annual meeting in Los Angeles.

Half the women studied were younger than 61, and the majority, 70 percent, had advanced cancer. First, the researchers looked to see how many women got treatment as recommended by the cancer network. The network is an alliance of 21 cancer centers that develops treatment guidelines.

Only 4,952, or 37 percent, got the recommended treatment.

Bristow's team looked at patient-related and health care system factors that might predict better adherence to treatment guidelines. They found the number of cases of ovarian cancer treated by the hospital and by individual doctors played a role.

"The high-volume hospitals, which did 20 or more cases a year, and high-volume physicians, which did 10 or more a year, were significantly more likely to administer treatment that was adherent to NCCN guidelines," Bristow said.