Aletti Giovanni D, Peiretti Michele
Division of Gynecologic Oncology, European Institute of Oncology, Milan, Italy.
Department of Surgical Sciences, Division of Gynecology and Obstetrics, University of Cagliari, Italy.
Best Pract Res Clin Obstet Gynaecol. 2017 May;41:96-107. doi: 10.1016/j.bpobgyn.2016.08.008. Epub 2016 Oct 1.
The optimal surgical management of patients with ovarian cancer includes a thorough staging with peritoneal and retroperitoneal assessment for early disease stages and a complete debulking with the removal of all macroscopic tumor for advanced disease stages. Disparities across different institutions in terms of optimal surgical management have been described. Surgical quality control programs constitute a real possibility to ensure and improve the quality of the surgery performed. Guidelines for surgery in early and advanced disease stages have been recently reviewed by the National Comprehensive Cancer Network (NCCN), and several quality indicators (QIs) have been proposed. These QIs can be used as a powerful tool to monitor, compare, and improve the quality of surgery across different centers and institutions. Furthermore, a transparent report of surgical outcomes through the creation of National and International Networks, adherence to the NCCN guidelines, and the establishment of quality control programs with a strong training and education component are key factors in enhancing the quality of surgery for patients with ovarian cancer.
卵巢癌患者的最佳手术管理包括对早期疾病阶段进行全面分期,进行腹膜和腹膜后评估,以及对晚期疾病阶段进行完全减瘤,切除所有肉眼可见的肿瘤。不同机构在最佳手术管理方面存在差异。手术质量控制计划确实有可能确保并提高手术质量。国家综合癌症网络(NCCN)最近对早期和晚期疾病阶段的手术指南进行了审查,并提出了一些质量指标(QIs)。这些质量指标可作为一个有力工具,用于监测、比较和提高不同中心和机构的手术质量。此外,通过建立国家和国际网络、遵守NCCN指南以及建立具有强大培训和教育组成部分的质量控制计划,透明地报告手术结果是提高卵巢癌患者手术质量的关键因素。