(reprinted with permission from Gregory Pawelski)
Elderly women with ovarian cancer tend to survive longer when treated by gynecologic oncologists than by general surgeons, according to results of a meta-analysis published in the Journal of the National Cancer Institute for February 1.
Dr. Craig C. Earle, from Dana-Farber Cancer Center in Boston, and his colleagues analyzed data from the Surveillance, Epidemiology and End Results (SEER) program for 3067 women aged 65 or older who underwent surgery for pathologically confirmed invasive epithelial ovarian cancer between 1992 and 1999.
These data were linked to Medicare data and American Medical Association files to obtain information about medical care they received and specialty type of the surgeon who performed cancer-related procedures. Records showed that 33% were operated on by a gynecologic oncologist, 45% by a general gynecologist, and 22% by a general surgeon.
Patients with stage I or stage II disease treated by gynecologic oncologists were more likely to undergo lymph node dissection (60% versus 36% by general gynecologists and 16% by general surgeons).
Those treated by gynecologic oncologists and general gynecologists were more likely to undergo a debulking procedure at the time of their first surgery than those operated on by general surgeons (58%, 51% and 40%, respectively) and to receive postoperative chemotherapy (79%, 76%, 62%).
Even though patients operated on by gynecologic oncologists tended to have more advanced disease at diagnosis, their survival rates were similar to those operated on by general gynecologists and better than those operated on by general surgeons (median survival 32.5 months, 35.6 months, and 24.3 months, respectively).
"Our data support professional societies' recommendations that it is preferable for ovarian cancer patients to be operated on by gynecologic oncologists when possible," Dr. Earle's group concludes.
SOURCE: J Natl Cancer Inst 2006;98:163-180.
Gregory D. Pawelski
Gregory D. Pawelski