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28-10-2015 | Gynecologic cancers | Article

Is It Time to Centralize Ovarian Cancer Care in the United States?

Journal:
Annals of Surgical Oncology

Authors: MD Renee A. Cowan, MD Roisin E. O’Cearbhaill, MD Ginger J. Gardner, MD Douglas A. Levine, MD Kara Long Roche, MD Yukio Sonoda, MD Oliver Zivanovic, MD William P. Tew, MD, PhD Evis Sala, MD Yulia Lakhman, MD Hebert A. Vargas Alvarez, MD Debra M. Sarasohn, MD Svetlana Mironov, MD Nadeem R. Abu-Rustum, MD Dennis S. Chi

Publisher: Springer International Publishing

Abstract

Purpose

The purpose of this article was to broadly review the most up-to-date information pertaining to the centralization of ovarian cancer care in the United States (US) and worldwide.

Methods

Much of the present literature pertaining to disparities in, and centralization of, ovarian cancer care in the US and internationally was reviewed, and specifically included original research and review articles.

Results

Data show improved optimal debulking rates, National Comprehensive Cancer Network (NCCN) guideline adherence, and overall survival rates in higher-volume, more specialized hospitals, and amongst higher-volume providers.

Conclusions

Patients with invasive epithelial ovarian cancer, especially those with higher stages (III and IV), are better served by centralized care in high-volume hospitals and by high-volume physicians, who adhere to NCCN guidelines wherever possible. More research is needed to determine the policy changes that can increase NCCN guideline adherence in low-volume hospitals and low-provider caseload scenarios. Policy and future research should be aimed at increasing patient access, either directly or indirectly, to high-volume hospital and high-volume providers, especially amongst Medicare, lower socioeconomic status, and minority patients.

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