Sundar Sudha, Nordin Andy, Morrison Jo, Wood Nick, Ghaem-Maghami Sadaf, Nieto Jo, Phillips Andrew, Butler John, Burton Kevin, Gornall Rob, Dobbs Stephen, Glasspool Rosalind, Peevor Richard, Ledermann Jonathan, McNeish Iain, Ratnavelu Nithya, Duncan Tim, Frost Jonathan, Lim Kenneth, Michael Agnieszka, Brockbank Elly, Gajjar Ketankumar, Taylor Alexandra, Bowen Rebecca, Andreou Adrian, Ganesan Raji, Nicum Shibani, Edmondson Richard, Clayton Richard, Balega Janos, Rolland Phil, Maxwell Hilary, Fotopoulou Christina
Pan Birmingham Gynaecological Cancer Centre, City Hospital and Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham B152TT, UK.
East Kent Hospitals University Foundation NHS Trust, Ethelburt Road, Canterbury CT1 3NG, UK.
Cancers (Basel). 2023 Jan 4;15(2):337. doi: 10.3390/cancers15020337.
Ovarian cancer survival in the UK lags behind comparable countries. Results from the ongoing National Ovarian Cancer Audit feasibility pilot (OCAFP) show that approximately 1 in 4 women with advanced ovarian cancer (Stage 2, 3, 4 and unstaged cancer) do not receive any anticancer treatment and only 51% in England receive international standard of care treatment, i.e., the combination of surgery and chemotherapy. The audit has also demonstrated wide variation in the percentage of women receiving anticancer treatment for advanced ovarian cancer, be it surgery or chemotherapy across the 19 geographical regions for organisation of cancer delivery (Cancer Alliances). Receipt of treatment also correlates with survival: 5 year Cancer survival varies from 28.6% to 49.6% across England. Here, we take a systems wide approach encompassing both diagnostic pathways and cancer treatment, derived from the whole cohort of women with ovarian cancer to set out recommendations and quality performance indicators (QPI). A multidisciplinary panel established by the British Gynaecological Cancer Society carefully identified QPI against criteria: metrics selected were those easily evaluable nationally using routinely available data and where there was a clear evidence base to support interventions. These QPI will be valuable to other taxpayer funded systems with national data collection mechanisms and are to our knowledge the only population level data derived standards in ovarian cancer. We also identify interventions for Best practice and Research recommendations.
英国卵巢癌患者的生存率落后于可比国家。正在进行的国家卵巢癌审计可行性试点（OCAFP）的结果显示，约四分之一的晚期卵巢癌（2期、3期、4期及分期不明的癌症）女性未接受任何抗癌治疗，在英格兰只有51%的患者接受了国际标准治疗，即手术和化疗相结合。该审计还表明，在19个癌症治疗组织地理区域（癌症联盟）中，接受晚期卵巢癌抗癌治疗（无论是手术还是化疗）的女性比例存在很大差异。接受治疗情况也与生存率相关：英格兰各地的5年癌症生存率从28.6%到49.6%不等。在此，我们采用一种涵盖诊断途径和癌症治疗的全系统方法，该方法源自整个卵巢癌女性队列，以提出建议和质量绩效指标（QPI）。英国妇科癌症协会成立的一个多学科小组根据标准仔细确定了QPI：选择的指标是那些利用常规可得数据在全国范围内易于评估且有明确证据支持干预措施的指标。这些QPI对其他有国家数据收集机制的由纳税人资助的系统将很有价值，据我们所知，它们是卵巢癌中仅有的基于人群水平数据得出的标准。我们还确定了最佳实践干预措施和研究建议。
