Trends in the surgical management of epithelial ovarian cancer in East Anglia 1995–2006

Abstract

Background Surveillance of trends in cancer management can help in service evaluation and quality improvement. Patients and methods We used East Anglia cancer registration data from 1995–2006 on 3063 patients with epithelial ovarian cancer. We described treatment patterns and examined their predictors using multivariate logistic regression. Results Use of chemotherapy (with/without surgery) and of surgery (with/without chemotherapy) remained stable over time (59% and 69% of patients, respectively). Use of surgery was less frequent in most deprived compared with most affluent patients (64% vs. 73% respectively; adjusted per increasing deprivation group quintile OR = 0.88, p = 0.001). Among patients treated by surgery, use of omentectomy and of exenteration increased over time (37% in 1995–8 vs. 56% in 2003–6 for omentectomy, and 2% vs. 8% for exenteration respectively, p < 0.001 for both). More deprived patients were less likely to be treated with omentectomy [42% vs. 53% for most deprived and more affluent patients respectively (adjusted OR = 0.91, p = 0.017)]. Conclusion Socioeconomic differences in use of ovarian cancer surgery require further elucidation. Use of some types of surgery increased over time, potentially reflecting changes in service organisation. The findings provide a ‘benchmark’ for future treatment pattern surveillance, and regional or international comparisons.