Department of Gynecologic Oncology, The Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland.
National Health Fund, Warsaw, Poland.
Med Sci Monit. 2023 Jan 18;29:e938776. doi: 10.12659/MSM.938776.
BACKGROUND Surgery is a cornerstone in management of ovarian and endometrial cancer. The European Society of Gynecological Oncology introduced quality indicators to improve management of these cancers. The optimal annual number of surgeries per unit was established for high-quality surgical treatment. MATERIAL AND METHODS The database of the National Health Fund on surgical management of endometrial and ovarian cancer was analyzed. Patients treated between 2017 and 2020 were included. Departments where patients underwent surgery were divided according to number of surgeries performed per year in endometrial cancer: ≥80, 79-50, 49-20, 19-0; and ovarian cancer: ≥100, 99-50, 49-20, 19-0. Optimal number of surgeries per center was defined as at least 100 and 80 surgeries per year in ovarian and endometrial cancer, respectively. RESULTS Totally, there were 22 325 surgeries in 316 units and 10 381 surgeries in 251 units due to endometrial and ovarian cancer, respectively. Most surgeries in endometrial cancer (n=15 077; 67.5%) and ovarian cancer (n=9642; 92.88%) were performed in departments that did not meet optimal criteria in number of surgeries. Between 2017 and 2019, an increasing trend in number of surgeries per year in endometrial and ovarian cancer was found. In 2020, there was a decrease in the number of surgeries by 7.8% (n=453) and 8.6% (n=234) in endometrial and ovarian cancer, respectively. CONCLUSIONS In Poland, surgical treatment of ovarian and endometrial cancer is decentralized. Most cancer patients underwent surgery in low-volume general gynecologic departments. The COVID-19 pandemic impaired cancer management, leading to a decreased number of surgeries.
手术是卵巢癌和子宫内膜癌治疗的基石。欧洲妇科肿瘤学会引入了质量指标，以改善这些癌症的治疗管理。已经为高质量手术治疗确定了每个单位每年最佳手术数量。
分析了国家卫生基金（National Health Fund）关于子宫内膜癌和卵巢癌手术管理的数据库。纳入了 2017 年至 2020 年期间接受治疗的患者。根据每年进行的手术数量将进行手术的科室在子宫内膜癌中分为以下几类：≥80、79-50、49-20、19-0；在卵巢癌中分为：≥100、99-50、49-20、19-0。将每个中心的最佳手术数量定义为卵巢癌和子宫内膜癌分别至少 100 次和 80 次手术。
共有 316 个科室进行了 22325 次手术，251 个科室进行了 10381 次手术，分别用于治疗子宫内膜癌和卵巢癌。大多数子宫内膜癌（n=15077；67.5%）和卵巢癌（n=9642；92.88%）手术都是在未达到手术数量最佳标准的科室进行的。在 2017 年至 2019 年期间，每年的手术数量在子宫内膜癌和卵巢癌中都呈上升趋势。2020 年，这两种癌症的手术数量分别减少了 7.8%（n=453）和 8.6%（n=234）。
在波兰，卵巢癌和子宫内膜癌的手术治疗较为分散。大多数癌症患者在低容量的普通妇科科室接受手术。COVID-19 大流行影响了癌症管理，导致手术数量减少。
