Abstract
e17048 Background: Treatment of AOC needs interdisciplinary and specialized skills and structures. We report the impact of a dedicated quality management program over 2 decades from learning curve and specialization process started in 1998-2004 when the surgical department was separated from a general clinic of obstetrics and gynecology. The next period from 2005-2010 covers the data after implementation of the first step of our ovarian cancer quality assurance program. In 2011, a dedicated department of GO was founded. Additionally, we investigated the role of subsequent centralized versus decentralized treatment when patients relapsed after they had primary therapy at our institution. Methods: Descriptive analysis of our prospective tumor registry including all consecutive patients with primary diagnosis of AOC FIGO IIB-IV treated from 1998-2004, 2005-2010 and 2011-2017. All patients having started any therapy outside of our center were excluded. Results: The number of patients with untreated AOC increased from 10 to 147 per year from 1998 to 2017. In total, 1,663 pts were analyzed. The annual percentage of FIGO IV increased from 14% in 1998 to 54-61% in recent years (2013-2017). The complete resection rate of upfront surgery was 50%, 67%, and 69% in the periods 1997-2004, 2005-2010, and 2011-2017, respectively. Correspondingly, median PFS increased from 19 to 21 and 26 months (p < 0.001) and median OS increased from 33 to 42 and 56 months, respectively (p < 0.001). Altogether, 893 pts (53.7%) experienced a relapse. 490/893 pts (54.9% of all ROC pts) were treated again in our center, the remaining 45.1% were treated somewhere else. Median OS calculated from first relapse was 43 months for patients re-treated in our institution versus 32 months for others (p < 0.001). Conclusions: We demonstrate a correlation between specialization and improved outcome in AOC. Focusing and implementing a quality assurance program including structural evolution from a department of general obstetrics/gynecology to a department of GO led to an improvement although systemic primary treatment standards did not change during this period.
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