Current status of ovarian cancer surgical management. Argument for centralisation of care in Australia

The Australian & New Zealand Journal of Obstetrics & Gynaecology
Jonathan CarterMarcelo Nascimento

Abstract

In Australia, ovarian cancer remains the most common cause of death among all the gynaecological malignancies, largely due to the fact that patients present at an advanced stage. Cytoreductive surgery has for a number of decades been the cornerstone of initial treatment for patients with advanced disease, where a smaller volume of residual disease (optimal cytoreduction) results in an improved outcome. Evidence indicates that optimal cytoreduction is best achieved by a certified gynaecological oncologist, and that subsequent management by a dedicated multidisciplinary team (MDT) results in patients more likely to receive 'evidenced based guideline care' and be offered participation in clinical trials. Patients managed by an MDT have been shown to have improved survival, their care to be cost effective and that they experience a high level of satisfaction and improved quality of life. Centralisation of care for patients with ovarian cancer should be considered gold standard care.

References

Nov 5, 1999·British Journal of Obstetrics and Gynaecology·E J JunorJ Young
Sep 10, 2003·Obstetrics and Gynecology·Solveig TingulstadBjørn Hagen
Sep 30, 2006·Annals of Surgical Oncology·Philipp HarterUNKNOWN AGO Ovarian Cancer Study Group
Jan 29, 2011·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Alison H Brand
Apr 18, 2012·Gynecologic Oncology·Yin Ling WooHeather O Dickinson
Aug 26, 2014·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Elizabeth TraceyBruce K Armstrong
Oct 30, 2015·Annals of Surgical Oncology·Renee A CowanDennis S Chi
Oct 29, 2017·Gynecologic Oncology·David I ShalowitzMarilyn M Schapira
Jan 18, 2018·The New England Journal of Medicine·Willemien J van DrielGabe S Sonke

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