Low-volume hospitals less likely to provide guideline-adherent care

The odds are better for women with ovarian cancer if they have guideline-recommended treatment--they're 30 percent less likely to die. But due to the type of hospitals at which they're treated, two-thirds of women with the disease do not receive such care.

Researchers found that women cared for in low-volume hospitals--hospitals that treat a small number of ovarian cancer patients--don't get the proper treatment that could save their lives, according to a study of about 13,000 patients presented at the Society of Gynecologic Oncology (SGO) Annual Meeting on Women's Cancer in Los Angeles.

Only 37.2 percent of patients in the study were treated according to National Comprehensive Cancer Network (NCCN) guidelines, Medscape Today reported.

"This shows a lot of room to improve," lead author Robert E. Bristow, M.D., director of the division of gynecologic oncology at the University of California, Irvine Medical Center, said Monday in a statement. "There may be a number of reasons women do not receive guideline-adherent care, such as that low-volume hospitals may not have access to gynecologic oncologists who specialize in this care," he noted.

The findings point to the need for patients to advocate for themselves, rather than being lead through treatment in a recommended course of care. "Patients need to be their own advocates and ask the provider and hospital how many ovarian cancer patients they treat, how many ovarian cancer surgeries they perform and their ovarian cancer patients' rates of survival. If a surgeon only performs two ovarian cancer surgeries a year, you don't want to be one of those two," Bristow said in the statement.

Moreover, the study marks the first large-scale population-based analysis to validate a connection between NCCN treatment recommendations and better clinical outcomes. But researchers notes that not every patient should receive guideline-recommended care.

"This is an interesting analysis .... [but] caution is advised in the interpretation of these population-based data," Maurie Markman, M.D., national director for medical oncology at the Cancer Treatment Centers of America, told Medscape Today.

Similarly, a recent study in the journal Cancer found that patients who received therapy at hospitals treating a high volume of head and neck cancers were 15 percent less likely to die, compared with those treated at hospitals with a lower number of those cancers.

To learn more:
- read the Medscape Today article
- read the announcement from the Society of Gynecologic Oncology

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