Impact of Ovarian Cancer Surgery Volume on Overall and Progression-Free Survival: A Population-Based Retrospective National French Study
Background Data are limited on the relationship between ovarian cancer surgery volume and outcomes in France. Methods For this retrospective, population-based study, patients with ovarian cancer that was diagnosed between January 1, 2012 and December 31, 2016 were identified from the French National...
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| Veröffentlicht in: | Annals of surgical oncology 2024-05, Vol.31 (5), p.3269-3279 |
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| creator | Prost, Pauline Duraes, Martha Georgescu, Vera Rebel, Lucie Mercier, Grégoire Rathat, Gauthier |
| description | Background
Data are limited on the relationship between ovarian cancer surgery volume and outcomes in France.
Methods
For this retrospective, population-based study, patients with ovarian cancer that was diagnosed between January 1, 2012 and December 31, 2016 were identified from the French National Health Data System (SNDS). Hospitals were classified in function of their ovarian cancer surgery volume. Patient, tumor, hospital, and hospital stay characteristics also were evaluated. The hospital procedure volume effect on 5-year overall survival (OS) and recurrence-free survival (RFS) was determined with Cox-proportional hazards models.
Results
This study included 8429 patients and 53.4% underwent cytoreductive surgery in hospitals with procedure volume < 20 cases/year. The 5-year OS rates were 63% and 60% in hospitals with procedure volume ≥ 20 and < 20 cases/year (
p
= 0.02). In multivariate analysis, OS and RFS were significantly increased when surgery was performed in hospitals doing ≥ 20 surgeries/year (vs. < 20) (hazard ratio HR = 1.18, 95% CI = 1.08–1.29 and HR = 1.10, 95% CI = 1.03–1.17). In the volume subgroup analysis, a difference was observed mainly between hospitals with < 10 surgeries/year and the other hospitals (HR = 1.27, 95% CI = 1.14–1.41 and HR = 1.14, 95% CI = 1.05–1.23). The patients’ age and comorbidities, tumor stage, and hospital stay (duration, first cytoreduction surgery) were associated with OS.
Conclusions
Ovarian cancer surgery volume ≥ 20 cases/year was significantly associated with improved OS and RFS but only with a limited clinical benefit. The biggest differences in OS and RFS were observed between hospitals with procedure volume < 10 cases/year and all the other hospitals. |
| doi_str_mv | 10.1245/s10434-024-15050-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3035078290</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3035078290</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-6c71d0f70925da082e9994a014bf081244fd5a580013b60f67e79036a65671603</originalsourceid><addsrcrecordid>eNp9kc9u1DAQxi0EoqXwAhyQJS69BMbxv5hbWbWlUtVWFLha3mRSUjlxsJOV9g147Dq7BSQOPdny95tvZvwR8pbBB1YK-TExEFwUUIqCSZBQwDNyyGR-Eqpiz_MdVFWYUskD8iqlewCmOciX5IBX3HCh2CH5fdGPrp5oaOn1xsXODXTlhhojvZ3jHcYt_RH83CMNQwYwOu-pGxp6E8NdxJS6MBRnEXHBN93G-U_0hN6EcfZuWrTPLmFDv-IUQxqxnroN0qud5DzNhUP9k95Oc7N9TV60zid883geke9np99WX4rL6_OL1cllUfNSTYWqNWug1WBK2TioSjTGCAdMrFuo8reItpFOVnlXvlbQKo3aAFdOSaWZAn5Ejve-Ywy_ZkyT7btUo_duwDAny4FL0FVpFvT9f-h9mGMefEdxrXM3k6lyT9V5xRSxtWPsehe3loFdcrL7nGzOye5ysov1u0fred1j87fkTzAZ4HsgZWnIQfzr_YTtA-eMnMo</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3033772449</pqid></control><display><type>article</type><title>Impact of Ovarian Cancer Surgery Volume on Overall and Progression-Free Survival: A Population-Based Retrospective National French Study</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Prost, Pauline ; Duraes, Martha ; Georgescu, Vera ; Rebel, Lucie ; Mercier, Grégoire ; Rathat, Gauthier</creator><creatorcontrib>Prost, Pauline ; Duraes, Martha ; Georgescu, Vera ; Rebel, Lucie ; Mercier, Grégoire ; Rathat, Gauthier</creatorcontrib><description>Background
Data are limited on the relationship between ovarian cancer surgery volume and outcomes in France.
Methods
For this retrospective, population-based study, patients with ovarian cancer that was diagnosed between January 1, 2012 and December 31, 2016 were identified from the French National Health Data System (SNDS). Hospitals were classified in function of their ovarian cancer surgery volume. Patient, tumor, hospital, and hospital stay characteristics also were evaluated. The hospital procedure volume effect on 5-year overall survival (OS) and recurrence-free survival (RFS) was determined with Cox-proportional hazards models.
Results
This study included 8429 patients and 53.4% underwent cytoreductive surgery in hospitals with procedure volume < 20 cases/year. The 5-year OS rates were 63% and 60% in hospitals with procedure volume ≥ 20 and < 20 cases/year (
p
= 0.02). In multivariate analysis, OS and RFS were significantly increased when surgery was performed in hospitals doing ≥ 20 surgeries/year (vs. < 20) (hazard ratio HR = 1.18, 95% CI = 1.08–1.29 and HR = 1.10, 95% CI = 1.03–1.17). In the volume subgroup analysis, a difference was observed mainly between hospitals with < 10 surgeries/year and the other hospitals (HR = 1.27, 95% CI = 1.14–1.41 and HR = 1.14, 95% CI = 1.05–1.23). The patients’ age and comorbidities, tumor stage, and hospital stay (duration, first cytoreduction surgery) were associated with OS.
Conclusions
Ovarian cancer surgery volume ≥ 20 cases/year was significantly associated with improved OS and RFS but only with a limited clinical benefit. The biggest differences in OS and RFS were observed between hospitals with procedure volume < 10 cases/year and all the other hospitals.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-024-15050-0</identifier><identifier>PMID: 38393461</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Cancer surgery ; Comorbidity ; Cytoreduction Surgical Procedures ; Disease-Free Survival ; Female ; Gynecologic Oncology ; Hospitals ; Humans ; Medicine ; Medicine & Public Health ; Multivariate analysis ; Oncology ; Ovarian cancer ; Ovarian Neoplasms - pathology ; Patients ; Population studies ; Proportional Hazards Models ; Retrospective Studies ; Surgery ; Surgical Oncology ; Survival ; Tumors</subject><ispartof>Annals of surgical oncology, 2024-05, Vol.31 (5), p.3269-3279</ispartof><rights>Society of Surgical Oncology 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. Society of Surgical Oncology.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-6c71d0f70925da082e9994a014bf081244fd5a580013b60f67e79036a65671603</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-024-15050-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-024-15050-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27922,27923,41486,42555,51317</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38393461$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Prost, Pauline</creatorcontrib><creatorcontrib>Duraes, Martha</creatorcontrib><creatorcontrib>Georgescu, Vera</creatorcontrib><creatorcontrib>Rebel, Lucie</creatorcontrib><creatorcontrib>Mercier, Grégoire</creatorcontrib><creatorcontrib>Rathat, Gauthier</creatorcontrib><title>Impact of Ovarian Cancer Surgery Volume on Overall and Progression-Free Survival: A Population-Based Retrospective National French Study</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
Data are limited on the relationship between ovarian cancer surgery volume and outcomes in France.
Methods
For this retrospective, population-based study, patients with ovarian cancer that was diagnosed between January 1, 2012 and December 31, 2016 were identified from the French National Health Data System (SNDS). Hospitals were classified in function of their ovarian cancer surgery volume. Patient, tumor, hospital, and hospital stay characteristics also were evaluated. The hospital procedure volume effect on 5-year overall survival (OS) and recurrence-free survival (RFS) was determined with Cox-proportional hazards models.
Results
This study included 8429 patients and 53.4% underwent cytoreductive surgery in hospitals with procedure volume < 20 cases/year. The 5-year OS rates were 63% and 60% in hospitals with procedure volume ≥ 20 and < 20 cases/year (
p
= 0.02). In multivariate analysis, OS and RFS were significantly increased when surgery was performed in hospitals doing ≥ 20 surgeries/year (vs. < 20) (hazard ratio HR = 1.18, 95% CI = 1.08–1.29 and HR = 1.10, 95% CI = 1.03–1.17). In the volume subgroup analysis, a difference was observed mainly between hospitals with < 10 surgeries/year and the other hospitals (HR = 1.27, 95% CI = 1.14–1.41 and HR = 1.14, 95% CI = 1.05–1.23). The patients’ age and comorbidities, tumor stage, and hospital stay (duration, first cytoreduction surgery) were associated with OS.
Conclusions
Ovarian cancer surgery volume ≥ 20 cases/year was significantly associated with improved OS and RFS but only with a limited clinical benefit. The biggest differences in OS and RFS were observed between hospitals with procedure volume < 10 cases/year and all the other hospitals.</description><subject>Cancer surgery</subject><subject>Comorbidity</subject><subject>Cytoreduction Surgical Procedures</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Gynecologic Oncology</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Multivariate analysis</subject><subject>Oncology</subject><subject>Ovarian cancer</subject><subject>Ovarian Neoplasms - pathology</subject><subject>Patients</subject><subject>Population studies</subject><subject>Proportional Hazards Models</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Survival</subject><subject>Tumors</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc9u1DAQxi0EoqXwAhyQJS69BMbxv5hbWbWlUtVWFLha3mRSUjlxsJOV9g147Dq7BSQOPdny95tvZvwR8pbBB1YK-TExEFwUUIqCSZBQwDNyyGR-Eqpiz_MdVFWYUskD8iqlewCmOciX5IBX3HCh2CH5fdGPrp5oaOn1xsXODXTlhhojvZ3jHcYt_RH83CMNQwYwOu-pGxp6E8NdxJS6MBRnEXHBN93G-U_0hN6EcfZuWrTPLmFDv-IUQxqxnroN0qud5DzNhUP9k95Oc7N9TV60zid883geke9np99WX4rL6_OL1cllUfNSTYWqNWug1WBK2TioSjTGCAdMrFuo8reItpFOVnlXvlbQKo3aAFdOSaWZAn5Ejve-Ywy_ZkyT7btUo_duwDAny4FL0FVpFvT9f-h9mGMefEdxrXM3k6lyT9V5xRSxtWPsehe3loFdcrL7nGzOye5ysov1u0fred1j87fkTzAZ4HsgZWnIQfzr_YTtA-eMnMo</recordid><startdate>20240501</startdate><enddate>20240501</enddate><creator>Prost, Pauline</creator><creator>Duraes, Martha</creator><creator>Georgescu, Vera</creator><creator>Rebel, Lucie</creator><creator>Mercier, Grégoire</creator><creator>Rathat, Gauthier</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TO</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20240501</creationdate><title>Impact of Ovarian Cancer Surgery Volume on Overall and Progression-Free Survival: A Population-Based Retrospective National French Study</title><author>Prost, Pauline ; Duraes, Martha ; Georgescu, Vera ; Rebel, Lucie ; Mercier, Grégoire ; Rathat, Gauthier</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-6c71d0f70925da082e9994a014bf081244fd5a580013b60f67e79036a65671603</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Cancer surgery</topic><topic>Comorbidity</topic><topic>Cytoreduction Surgical Procedures</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Gynecologic Oncology</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Multivariate analysis</topic><topic>Oncology</topic><topic>Ovarian cancer</topic><topic>Ovarian Neoplasms - pathology</topic><topic>Patients</topic><topic>Population studies</topic><topic>Proportional Hazards Models</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Survival</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Prost, Pauline</creatorcontrib><creatorcontrib>Duraes, Martha</creatorcontrib><creatorcontrib>Georgescu, Vera</creatorcontrib><creatorcontrib>Rebel, Lucie</creatorcontrib><creatorcontrib>Mercier, Grégoire</creatorcontrib><creatorcontrib>Rathat, Gauthier</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Prost, Pauline</au><au>Duraes, Martha</au><au>Georgescu, Vera</au><au>Rebel, Lucie</au><au>Mercier, Grégoire</au><au>Rathat, Gauthier</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of Ovarian Cancer Surgery Volume on Overall and Progression-Free Survival: A Population-Based Retrospective National French Study</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2024-05-01</date><risdate>2024</risdate><volume>31</volume><issue>5</issue><spage>3269</spage><epage>3279</epage><pages>3269-3279</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Background
Data are limited on the relationship between ovarian cancer surgery volume and outcomes in France.
Methods
For this retrospective, population-based study, patients with ovarian cancer that was diagnosed between January 1, 2012 and December 31, 2016 were identified from the French National Health Data System (SNDS). Hospitals were classified in function of their ovarian cancer surgery volume. Patient, tumor, hospital, and hospital stay characteristics also were evaluated. The hospital procedure volume effect on 5-year overall survival (OS) and recurrence-free survival (RFS) was determined with Cox-proportional hazards models.
Results
This study included 8429 patients and 53.4% underwent cytoreductive surgery in hospitals with procedure volume < 20 cases/year. The 5-year OS rates were 63% and 60% in hospitals with procedure volume ≥ 20 and < 20 cases/year (
p
= 0.02). In multivariate analysis, OS and RFS were significantly increased when surgery was performed in hospitals doing ≥ 20 surgeries/year (vs. < 20) (hazard ratio HR = 1.18, 95% CI = 1.08–1.29 and HR = 1.10, 95% CI = 1.03–1.17). In the volume subgroup analysis, a difference was observed mainly between hospitals with < 10 surgeries/year and the other hospitals (HR = 1.27, 95% CI = 1.14–1.41 and HR = 1.14, 95% CI = 1.05–1.23). The patients’ age and comorbidities, tumor stage, and hospital stay (duration, first cytoreduction surgery) were associated with OS.
Conclusions
Ovarian cancer surgery volume ≥ 20 cases/year was significantly associated with improved OS and RFS but only with a limited clinical benefit. The biggest differences in OS and RFS were observed between hospitals with procedure volume < 10 cases/year and all the other hospitals.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>38393461</pmid><doi>10.1245/s10434-024-15050-0</doi><tpages>11</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Annals of surgical oncology, 2024-05, Vol.31 (5), p.3269-3279 |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Cancer surgery Comorbidity Cytoreduction Surgical Procedures Disease-Free Survival Female Gynecologic Oncology Hospitals Humans Medicine Medicine & Public Health Multivariate analysis Oncology Ovarian cancer Ovarian Neoplasms - pathology Patients Population studies Proportional Hazards Models Retrospective Studies Surgery Surgical Oncology Survival Tumors |
| title | Impact of Ovarian Cancer Surgery Volume on Overall and Progression-Free Survival: A Population-Based Retrospective National French Study |
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