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Exploring international differences in ovarian cancer treatment: a comparison of clinical practice guidelines and patterns of care

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Harvard

Norell, CH, Butler, J, Farrell, R, Altman, A, Bentley, J, Cabasag, CJ, Cohen, PA, Fegan, S, Fung-Kee-Fung, M, Gourley, C, Hacker, NF, Hanna, L, Høgdall, CK, Kristensen, G, Kwon, J, McNally, O, Nelson, G, Nordin, A, O'Donnell, D, Schnack, T, Sykes, PH, Zotow, E & Harrison, S 2020, 'Exploring international differences in ovarian cancer treatment: a comparison of clinical practice guidelines and patterns of care', International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, bind 30, nr. 11, s. 1748-1756. https://doi.org/10.1136/ijgc-2020-001403

APA

Norell, C. H., Butler, J., Farrell, R., Altman, A., Bentley, J., Cabasag, C. J., Cohen, P. A., Fegan, S., Fung-Kee-Fung, M., Gourley, C., Hacker, N. F., Hanna, L., Høgdall, C. K., Kristensen, G., Kwon, J., McNally, O., Nelson, G., Nordin, A., O'Donnell, D., ... Harrison, S. (2020). Exploring international differences in ovarian cancer treatment: a comparison of clinical practice guidelines and patterns of care. International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, 30(11), 1748-1756. https://doi.org/10.1136/ijgc-2020-001403

CBE

Norell CH, Butler J, Farrell R, Altman A, Bentley J, Cabasag CJ, Cohen PA, Fegan S, Fung-Kee-Fung M, Gourley C, Hacker NF, Hanna L, Høgdall CK, Kristensen G, Kwon J, McNally O, Nelson G, Nordin A, O'Donnell D, Schnack T, Sykes PH, Zotow E, Harrison S. 2020. Exploring international differences in ovarian cancer treatment: a comparison of clinical practice guidelines and patterns of care. International journal of gynecological cancer : official journal of the International Gynecological Cancer Society. 30(11):1748-1756. https://doi.org/10.1136/ijgc-2020-001403

MLA

Vancouver

Author

Norell, Charles H ; Butler, John ; Farrell, Rhonda ; Altman, Alon ; Bentley, James ; Cabasag, Citadel J ; Cohen, Paul A ; Fegan, Scott ; Fung-Kee-Fung, Michael ; Gourley, Charlie ; Hacker, Neville F ; Hanna, Louise ; Høgdall, Claus Kim ; Kristensen, Gunnar ; Kwon, Janice ; McNally, Orla ; Nelson, Gregg ; Nordin, Andy ; O'Donnell, Dearbhaile ; Schnack, Tine ; Sykes, Peter H ; Zotow, Ewa ; Harrison, Samantha. / Exploring international differences in ovarian cancer treatment : a comparison of clinical practice guidelines and patterns of care. I: International journal of gynecological cancer : official journal of the International Gynecological Cancer Society. 2020 ; Bind 30, Nr. 11. s. 1748-1756.

Bibtex

@article{19e86076480945d588f34ccd6effb2cb,
title = "Exploring international differences in ovarian cancer treatment: a comparison of clinical practice guidelines and patterns of care",
abstract = "INTRODUCTION: The International Cancer Benchmarking Partnership demonstrated international differences in ovarian cancer survival, particularly for women aged 65-74 with advanced disease. These findings suggest differences in treatment could be contributing to survival disparities.OBJECTIVE: To compare clinical practice guidelines and patterns of care across seven high-income countries.METHODS: A comparison of guidelines was performed and validated by a clinical working group. To explore clinical practice, a patterns of care survey was developed. A questionnaire regarding management and potential health system-related barriers to providing treatment was emailed to gynecological specialists. Guideline and survey results were crudely compared with 3-year survival by 'distant' stage using Spearman's rho.RESULTS: Twenty-seven guidelines were compared, and 119 clinicians completed the survey. Guideline-related measures varied between countries but did not correlate with survival internationally. Guidelines were consistent for surgical recommendations of either primary debulking surgery or neoadjuvant chemotherapy followed by interval debulking surgery with the aim of complete cytoreduction. Reported patterns of surgical care varied internationally, including for rates of primary versus interval debulking, extensive/'ultra-radical' surgery, and perceived barriers to optimal cytoreduction. Comparison showed that willingness to undertake extensive surgery correlated with survival across countries (rs=0.94, p=0.017). For systemic/radiation therapies, guideline differences were more pronounced, particularly for bevacizumab and PARP (poly (ADP-ribose) polymerase) inhibitors. Reported health system-related barriers also varied internationally and included a lack of adequate hospital staffing and treatment monitoring via local and national audits.DISCUSSION: Findings suggest international variations in ovarian cancer treatment. Characteristics relating to countries with higher stage-specific survival included higher reported rates of primary surgery; willingness to undertake extensive/ultra-radical procedures; greater access to high-cost drugs; and auditing.",
keywords = "medical oncology, ovarian cancer, surgery, surgical oncology",
author = "Norell, {Charles H} and John Butler and Rhonda Farrell and Alon Altman and James Bentley and Cabasag, {Citadel J} and Cohen, {Paul A} and Scott Fegan and Michael Fung-Kee-Fung and Charlie Gourley and Hacker, {Neville F} and Louise Hanna and H{\o}gdall, {Claus Kim} and Gunnar Kristensen and Janice Kwon and Orla McNally and Gregg Nelson and Andy Nordin and Dearbhaile O'Donnell and Tine Schnack and Sykes, {Peter H} and Ewa Zotow and Samantha Harrison",
note = "{\textcopyright} IGCS and ESGO 2020. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ.",
year = "2020",
month = nov,
doi = "10.1136/ijgc-2020-001403",
language = "English",
volume = "30",
pages = "1748--1756",
journal = "International Journal of Gynecological Cancer",
issn = "1048-891X",
publisher = "Lippincott Williams & Wilkins",
number = "11",

}

RIS

TY - JOUR

T1 - Exploring international differences in ovarian cancer treatment

T2 - a comparison of clinical practice guidelines and patterns of care

AU - Norell, Charles H

AU - Butler, John

AU - Farrell, Rhonda

AU - Altman, Alon

AU - Bentley, James

AU - Cabasag, Citadel J

AU - Cohen, Paul A

AU - Fegan, Scott

AU - Fung-Kee-Fung, Michael

AU - Gourley, Charlie

AU - Hacker, Neville F

AU - Hanna, Louise

AU - Høgdall, Claus Kim

AU - Kristensen, Gunnar

AU - Kwon, Janice

AU - McNally, Orla

AU - Nelson, Gregg

AU - Nordin, Andy

AU - O'Donnell, Dearbhaile

AU - Schnack, Tine

AU - Sykes, Peter H

AU - Zotow, Ewa

AU - Harrison, Samantha

N1 - © IGCS and ESGO 2020. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ.

PY - 2020/11

Y1 - 2020/11

N2 - INTRODUCTION: The International Cancer Benchmarking Partnership demonstrated international differences in ovarian cancer survival, particularly for women aged 65-74 with advanced disease. These findings suggest differences in treatment could be contributing to survival disparities.OBJECTIVE: To compare clinical practice guidelines and patterns of care across seven high-income countries.METHODS: A comparison of guidelines was performed and validated by a clinical working group. To explore clinical practice, a patterns of care survey was developed. A questionnaire regarding management and potential health system-related barriers to providing treatment was emailed to gynecological specialists. Guideline and survey results were crudely compared with 3-year survival by 'distant' stage using Spearman's rho.RESULTS: Twenty-seven guidelines were compared, and 119 clinicians completed the survey. Guideline-related measures varied between countries but did not correlate with survival internationally. Guidelines were consistent for surgical recommendations of either primary debulking surgery or neoadjuvant chemotherapy followed by interval debulking surgery with the aim of complete cytoreduction. Reported patterns of surgical care varied internationally, including for rates of primary versus interval debulking, extensive/'ultra-radical' surgery, and perceived barriers to optimal cytoreduction. Comparison showed that willingness to undertake extensive surgery correlated with survival across countries (rs=0.94, p=0.017). For systemic/radiation therapies, guideline differences were more pronounced, particularly for bevacizumab and PARP (poly (ADP-ribose) polymerase) inhibitors. Reported health system-related barriers also varied internationally and included a lack of adequate hospital staffing and treatment monitoring via local and national audits.DISCUSSION: Findings suggest international variations in ovarian cancer treatment. Characteristics relating to countries with higher stage-specific survival included higher reported rates of primary surgery; willingness to undertake extensive/ultra-radical procedures; greater access to high-cost drugs; and auditing.

AB - INTRODUCTION: The International Cancer Benchmarking Partnership demonstrated international differences in ovarian cancer survival, particularly for women aged 65-74 with advanced disease. These findings suggest differences in treatment could be contributing to survival disparities.OBJECTIVE: To compare clinical practice guidelines and patterns of care across seven high-income countries.METHODS: A comparison of guidelines was performed and validated by a clinical working group. To explore clinical practice, a patterns of care survey was developed. A questionnaire regarding management and potential health system-related barriers to providing treatment was emailed to gynecological specialists. Guideline and survey results were crudely compared with 3-year survival by 'distant' stage using Spearman's rho.RESULTS: Twenty-seven guidelines were compared, and 119 clinicians completed the survey. Guideline-related measures varied between countries but did not correlate with survival internationally. Guidelines were consistent for surgical recommendations of either primary debulking surgery or neoadjuvant chemotherapy followed by interval debulking surgery with the aim of complete cytoreduction. Reported patterns of surgical care varied internationally, including for rates of primary versus interval debulking, extensive/'ultra-radical' surgery, and perceived barriers to optimal cytoreduction. Comparison showed that willingness to undertake extensive surgery correlated with survival across countries (rs=0.94, p=0.017). For systemic/radiation therapies, guideline differences were more pronounced, particularly for bevacizumab and PARP (poly (ADP-ribose) polymerase) inhibitors. Reported health system-related barriers also varied internationally and included a lack of adequate hospital staffing and treatment monitoring via local and national audits.DISCUSSION: Findings suggest international variations in ovarian cancer treatment. Characteristics relating to countries with higher stage-specific survival included higher reported rates of primary surgery; willingness to undertake extensive/ultra-radical procedures; greater access to high-cost drugs; and auditing.

KW - medical oncology

KW - ovarian cancer

KW - surgery

KW - surgical oncology

UR - http://www.scopus.com/inward/record.url?scp=85090790879&partnerID=8YFLogxK

U2 - 10.1136/ijgc-2020-001403

DO - 10.1136/ijgc-2020-001403

M3 - Journal article

C2 - 32784203

VL - 30

SP - 1748

EP - 1756

JO - International Journal of Gynecological Cancer

JF - International Journal of Gynecological Cancer

SN - 1048-891X

IS - 11

ER -

ID: 61424331