Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Norway.
Int J Gynecol Cancer. 2012 Feb;22(2):226-31. doi: 10.1097/IGC.0b013e31823589ef.
Better outcome of advanced ovarian cancer after centralized surgery has led to the recommendation for centralized surgery in a Norwegian health region. Whether the practice pattern has changed according to this recommendation has not been examined.
The objective of this study was to evaluate the referral practice and treatment of ovarian cancer in a Norwegian health region after the introduction of centralized surgery.
This was a retrospective, population-based study, including all women undergoing surgery for primary ovarian, tubal, and peritoneal cancer between 2000 and 2005, in Health Region IV of Norway. Clinical data and data regarding treatment and 5-year follow-up were analyzed.
In total, 279 cases of ovarian, peritoneal, and tubal cancer were included. Eighty-four percent underwent primary surgery at the teaching hospital and 16% at the nonteaching hospitals. After an immediate rise in the number of cases undergoing primary surgery at the teaching hospital after the introduction of centralization in 1995, the percentage distribution between the teaching and nonteaching hospitals was stable during the study period. The women who underwent surgery at the nonteaching hospitals had a higher percentage of early-stage disease and were at higher risk of reoperation for comprehensive staging.
Centralization of ovarian cancer surgery has been successfully accomplished in a health region in Norway. The referral practice of assumed advanced ovarian cancer cases shows satisfactory compliance with centralization at 10 years after the implementation of centralized surgery.
集中手术可提高晚期卵巢癌的治疗效果，因此挪威的一个卫生区域推荐进行集中手术。但是否根据该建议改变了手术实践模式尚未进行研究。
本研究旨在评估挪威一个卫生区域在实施集中手术之后卵巢癌的转诊实践和治疗情况。
这是一项回顾性的基于人群的研究，纳入了 2000 年至 2005 年间在挪威第四卫生区域内接受原发性卵巢癌、输卵管癌和腹膜癌手术的所有女性。分析了临床数据以及治疗和 5 年随访数据。
共纳入 279 例卵巢癌、腹膜癌和输卵管癌患者。84%的患者在教学医院接受了原发性手术，16%的患者在非教学医院接受了原发性手术。1995 年集中化后，教学医院接受原发性手术的病例数立即增加，此后，在研究期间，教学医院和非教学医院之间的病例分布百分比保持稳定。在非教学医院接受手术的女性中，早期疾病的比例更高，且进行全面分期再手术的风险更高。
在挪威的一个卫生区域成功实施了卵巢癌手术的集中化。10 年集中手术实施后，假设的晚期卵巢癌病例的转诊实践与集中化具有良好的一致性。
