Gynaecological Surgery, Cliniques universitaires Saint-Luc, Brussels, Belgium
TIL's Group - De Duve Institute, UCLouvain, Brussels, Belgium.
Int J Gynecol Cancer. 2024 Jan 5;34(1):106-112. doi: 10.1136/ijgc-2023-004401.
In Belgium there is no centralization of surgery for ovarian cancer, with more than 100 centers treating around 800 cases per year. In 2017 a network with several collaborating hospitals was established to centralize surgery for ovarian cancer (UCLouvain Network of Gynecological Oncology; UNGO) following publication of the European Society of Gynecological Oncology (ESGO) recommendations and quality criteria for surgery of advanced ovarian cancer. We obtained ESGO accreditation in 2019.
We retrospectively collected data associated with patients undergoing surgery in our institution from 2007 to 2016, before the creation of the network (cohort 1) and, following the establishment of UNGO (2017-2021), patients undergoing surgery were prospectively registered in a REDCap database (cohort 2). The outcomes of the two cohorts were compared.
A total of 314 patients underwent surgery in our institution from 2007 and 2021: 7.5 patients/year in cohort 1 (retrospective, 2007-2016) and 40.8 patients/year in cohort 2 (after network creation, 2017-2021). Median disease-free survival was increased from 16.5 months (range 13.2-20.4) in cohort 1 to 27.1 months (range 21.5-33.2) in cohort 2 (p=0.0004). In cohort 2, the rate of patients with residual disease at the end of the surgery was significantly less (18.7% vs 8.8%, p=0.023), although more patients in cohort 1 received neoadjuvant chemotherapy (89% vs 54%, p<0.001). However, there was a higher rate of complications in the patients in cohort 2 (18.8% vs 30%, p=0.041).
Our study shows that, with the help of ESGO and its recommendations, we have been able to create an efficient advanced ovarian cancer centralized network and this may provide an improvement in the quality of care.
在比利时，卵巢癌的手术并未集中进行，有超过 100 个中心每年治疗约 800 例患者。2017 年，在欧洲妇科肿瘤学会（ESGO）发布关于晚期卵巢癌手术的建议和质量标准后，为集中治疗卵巢癌，成立了一个由多家合作医院组成的网络（鲁汶大学妇科肿瘤学网络；UNGO）。我们于 2019 年获得了 ESGO 认证。
我们回顾性地收集了我院 2007 年至 2016 年（网络建立前）和 2017 年至 2021 年（UNGO 建立后）接受手术治疗的患者数据。在两个队列中，将网络建立前（回顾性，2007-2016 年）的患者纳入队列 1，网络建立后（前瞻性，2017-2021 年）的患者纳入队列 2。比较两组患者的结局。
我院共有 314 例患者接受手术治疗，分别为队列 1（回顾性，2007-2016 年）中的 7.5 例/年和队列 2（网络建立后，2017-2021 年）中的 40.8 例/年。队列 2 患者的无疾病生存期中位数从 16.5 个月（范围 13.2-20.4）延长至 27.1 个月（范围 21.5-33.2）（p=0.0004）。队列 2 中，手术结束时残余疾病患者的比例显著降低（18.7%比 8.8%，p=0.023），尽管队列 1 中接受新辅助化疗的患者更多（89%比 54%，p<0.001）。然而，队列 2 中的并发症发生率更高（18.8%比 30%，p=0.041）。
我们的研究表明，在 ESGO 及其建议的帮助下，我们成功建立了一个高效的晚期卵巢癌集中网络，这可能提高了治疗质量。
