Alejandra Martinez, Gertych Witold, Pomel Christophe, Ferron Gwenael, Lusque Amelie, Angeles Martina Aida, Lambaudie Eric, Rouzier Roman, Bakrin Naoual, Golfier Francois, Glehen Olivier, Canis Michel, Bourdel Nicolas, Pouget Nicolas, Colombo Pierre-Emmanuel, Guyon Frédéric, Meurette Jacques, Querleu Denis
Surgical Oncology Department, Institut Claudius Regaud, Institut Universitaire du Cancer-Toulouse Oncopole, 59500 Toulouse, France.
Cancer Research Center of Toulouse (CRCT), INSERM UMR 1037, 31037 Toulouse, France.
Cancers (Basel). 2021 Mar 30;13(7):1593. doi: 10.3390/cancers13071593.
Quality Indicators for ovarian cancer (OC) have been developed by the European Society of Gynaecological Oncology (ESGO) and by the French National Cancer Institute (Institut National du Cancer, INCa). The aim of the study was to characterize OC care distribution in France by case-volume and to prospectively evaluate the adherence of high-volume institutions to INCa/ESGO quality indicators.
The cost-utility of radical surgery in ovarian cancer (CURSOC) trial is a prospective, multicenter, comparative and non-randomized study that includes patients with stage IIIC-IV epithelial OC treated in nine French health care tertiary institutions. Adherence to institutional quality indicators were anonymously assessed by an independent committee. OC care distribution in France were provided by the nationwide database of hospital procedures.
More than half of patients are treated in low-volume institutions. Among the nine high-volume centers participating in the study, four (44.4%) met all institutional INCa/ESGO quality indicators. The other five (55.6%) did not fulfil one of the quality indicator criteria.
Access to high-volume OC providers in France is restricted to a minority of patients, and yet half of the referral institutions included in this study failed to meet all recommended institutional quality indicators. It is mandatory that national authorities work both to improve OC centralization and to incorporate quality assurance programs into certified centers.
欧洲妇科肿瘤学会（ESGO）和法国国家癌症研究所（INCa）已制定了卵巢癌（OC）质量指标。本研究的目的是按病例数量描述法国OC护理的分布情况，并前瞻性评估高病例量机构对INCa/ESGO质量指标的遵守情况。
卵巢癌根治性手术的成本效用（CURSOC）试验是一项前瞻性、多中心、比较性和非随机研究，纳入了在法国9家三级医疗机构接受治疗的IIIC-IV期上皮性OC患者。由一个独立委员会对机构质量指标的遵守情况进行匿名评估。法国OC护理的分布情况由全国医院手术数据库提供。
超过一半的患者在低病例量机构接受治疗。在参与研究的9个高病例量中心中，有4个（44.4%）符合所有机构INCa/ESGO质量指标。另外5个（55.6%）未达到其中一项质量指标标准。
在法国，只有少数患者能够获得高病例量OC医疗服务提供者的治疗，而且本研究中纳入的转诊机构中有一半未能达到所有推荐的机构质量指标。国家当局必须努力改善OC治疗的集中化，并将质量保证计划纳入认证中心。
