We now understand that the main driver of improved outcomes of surgery is being able to debulk those patients to no visible disease. That is the gold standard outcome for patients with advanced ovary cancer.
—Robert E. Bristow, MD, MBA
“Patients are becoming more sophisticated in their ability and willingness to interrogate the health-care system about their care,” according to Robert E. Bristow, MD, MBA, lead author of the study finding that many women with ovarian cancer are not receiving care consistent with National Comprehensive Cancer Network (NCCN) Guidelines. Dr. Bristow is the Director of the Division of Gynecologic Oncology, University of California, Irvine.
It is becoming more and more common, he said, for patients with ovarian cancer to ask physicians how many surgical procedures for ovarian cancer they do each year. Other questions to expect include: What are your outcomes? What is your patient survival rate? What percentage of your patients get intraperitoneal chemotherapy, and how do they do afterward? What percentage of patients with advanced disease are able to have an optimal or complete debulking?
“We now understand that the main driver of improved outcomes of surgery is being able to debulk those patients to no visible disease. That is the gold standard outcome for patients with advanced ovary cancer—complete debulking down to no gross residual disease,” Dr. Bristow said.
He cited an abstract presented at the Society of Gynecologic Oncology meeting last year1: A subanalysis of data from Gynecologic Oncology Group (GOG) 172 looked at whether patients with stage III ovarian cancer that received intraperitoneal therapy had complete debulking to no visible disease, or whether they had debulking to 1 to 10 mm of residual disease. “For those patients taken down to no visible disease who got intraperitoneal chemotherapy, the median survival was 127 months—10½ years—which is like a Star Trek number for advanced ovary cancer survival,” Dr. Bristow said. ■
1. Landrum L, Java J, Matthews C, et al: Prognostic factors for stage III epithelial ovarian cancer treated with intraperitoneal chemotherapy: A Gynecologic Oncology Group study. Abstract 56. Gynecol Oncol 125:S24, 2012.
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