Dutch study cites better survival rates, but one expert urges caution
TUESDAY, March 11 (HealthDay News) -- Treatment at semi-specialized or specialized hospitals improved survival time for ovarian cancer patients, a Dutch study found.
For the study, the researchers examined data on 8,621 ovarian cancer patients treated in the Netherlands between 1996 and 2003. Of those women, 40 percent were treated in general hospitals, 41 percent in semi-specialized hospitals, and 18 percent in specialized hospitals. Five-year survival was 38 percent, 39.4 percent, and 40.3 percent, respectively.
The University Medical Center Utrecht researchers said the difference was statistically significant for women ages 50 to 75 who were diagnosed with early ovarian cancer. Their risk of death decreased by 30 percent (semi-specialized hospital) and 42 percent (specialized hospital), compared to those treated at a general hospital.
"This result indicates that the level of collaboration during the study period did not suffice to deliver optimal care to all Dutch ovarian cancer patients, and regionalization of the care for such patients thus seems necessary," the researchers wrote.
The study was published online March 11 in the Journal of the National Cancer Institute.
While this and other studies that correlate patterns of care and clinical outcomes are important, they need to be interpreted with caution, Dr. Deborah Schrag, of the Dana-Farber Cancer Institute in Boston, wrote in an accompanying editorial. Confounding variables and information that isn't tracked in such studies can lead to inaccurate conclusions, she warned.
For example, in the Dutch study, the ages and types of treatment received by ovarian cancer patients at general hospitals appeared to be different than those of patients treated at semi-specialized and specialized hospitals. In addition, there was no information about other health issues that may have affected patient results.
"Therefore, this analysis, in and of itself, does not justify regionalization of ovarian cancer surgery in the Netherlands to specialty centers," Schrag wrote.
In order to achieve more accurate analyses, cancer registries need to collect a wider range of information, she suggested.
"As the number of cancer therapies increases, and as the need to systematically evaluate their real-world clinical effectiveness grows, there is a need to optimize the data that can be gleaned from observational data sources," Schrag wrote. "A compelling case can be made for expanding the scope of data that tumor registries collect."
The American Cancer Society has more about ovarian cancer treatment.
-- Robert Preidt
SOURCE: Journal of the National Cancer Institute, news release, March 11, 2008
All rights reserved