Display options
Cite
Fung-Kee-Fung M, Kennedy EB, Biagi J, et al. The optimal organization of gynecologic oncology services: a systematic review. Curr Oncol. 2015;22(4):e282-93doi: 10.3747/co.22.2482.
Fung-Kee-Fung, M., Kennedy, E. B., Biagi, J., Colgan, T., D'Souza, D., Elit, L. M., Hunter, A., Irish, J., McLeod, R., & Rosen, B. (2015). The optimal organization of gynecologic oncology services: a systematic review. Current oncology (Toronto, Ont.), 22(4), e282-93. https://doi.org/10.3747/co.22.2482
Fung-Kee-Fung, M, et al. "The optimal organization of gynecologic oncology services: a systematic review." Current oncology (Toronto, Ont.) vol. 22,4 (2015): e282-93. doi: https://doi.org/10.3747/co.22.2482
Fung-Kee-Fung M, Kennedy EB, Biagi J, Colgan T, D'Souza D, Elit LM, Hunter A, Irish J, McLeod R, Rosen B. The optimal organization of gynecologic oncology services: a systematic review. Curr Oncol. 2015 Aug;22(4):e282-93. doi: 10.3747/co.22.2482. PMID: 26300679; PMCID: PMC4530826.
Copy Download .nbib Format: NLM
Share it on

Curr Oncol. 2015 Aug;22(4):e282-93. doi: 10.3747/co.22.2482.

The optimal organization of gynecologic oncology services: a systematic review.

Current oncology (Toronto, Ont.)

M Fung-Kee-Fung, E B Kennedy, J Biagi, T Colgan, D D'Souza, L M Elit, A Hunter, J Irish, R McLeod, B Rosen

Affiliations

  1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON;
  2. Program in Evidence-Based Care, Cancer Care Ontario, and Department of Oncology, McMaster University, Hamilton, ON;
  3. Southeastern Ontario Health Sciences Centre, Palliative Care Medicine Program, Kingston, ON;
  4. Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON;
  5. London Regional Cancer Program, London, ON;
  6. Juravinski Cancer Centre and McMaster University, Hamilton, ON;
  7. Surgical Oncology Program, Cancer Care Ontario, Toronto, ON;
  8. Department of Gynecology-Oncology, Princess Margaret Hospital, Toronto, ON.

PMID: 26300679 PMCID: PMC4530826 DOI: 10.3747/co.22.2482

Abstract

BACKGROUND: A system-level organizational guideline for gynecologic oncology was identified by a provincial cancer agency as a key priority based on input from stakeholders, data showing more limited availability of multidisciplinary or specialist care in lower-volume than in higher-volume hospitals in the relevant jurisdiction, and variable rates of staging for ovarian and endometrial cancer patients.

METHODS: A systematic review assessed the relationship of the organization of gynecologic oncology services with patient survival and surgical outcomes. The electronic databases medline and embase (ovid: 1996 through 9 January 2015) were searched using terms related to gynecologic malignancies combined with organization of services, patterns of care, and various facility and physician characteristics. Outcomes of interest included overall or disease-specific survival, short-term survival, adequate staging, and degree of cytoreduction or optimal cytoreduction (or both) for ovarian cancer patients by hospital or physician type, and rate of discrepancy in initial diagnoses and intraoperative consultation between non-specialist pathologists and gyne-oncology-specialist pathologists.

RESULTS: One systematic review and sixteen additional primary studies met the inclusion criteria. The evidence base as a whole was judged to be of lower quality; however, a trend toward improved outcomes with centralization of gynecologic oncology was found, particularly with respect to the gynecologic oncology care of patients with advanced-stage ovarian cancer.

CONCLUSIONS: Improvements in outcomes with centralization of gynecologic oncology services can be attributed to a number of factors, including access to specialist care and multidisciplinary team management. Findings of this systematic review should be used with caution because of the limitations of the evidence base; however, an expert consensus process made it possible to create recommendations for implementation.

Keywords: Organization; gynecologic oncology; systematic reviews

References

  1. CMAJ. 2010 Dec 14;182(18):E839-42 - PubMed
  2. Br J Obstet Gynaecol. 1998 Feb;105(2):200-5 - PubMed
  3. Eur J Gynaecol Oncol. 2009;30(4):361-4 - PubMed
  4. Gynecol Oncol. 2003 Apr;89(1):4-8 - PubMed
  5. Int J Gynecol Cancer. 2009 Jan;19(1):152-7 - PubMed
  6. Gynecol Oncol. 2005 Nov;99(2):447-61 - PubMed
  7. Gynecol Oncol. 2010 Apr;117(1):18-22 - PubMed
  8. J Obstet Gynaecol Can. 2009 Jul;31(7):668-80 - PubMed
  9. Gynecol Oncol. 2009 Dec;115(3):343-8 - PubMed
  10. BMC Med Res Methodol. 2007 Feb 15;7:10 - PubMed
  11. Gynecol Oncol. 2010 Sep;118(3):262-7 - PubMed
  12. PLoS One. 2009;4(1):e4049 - PubMed
  13. BJOG. 2012 Jan;119(2):160-5 - PubMed
  14. Int J Gynaecol Obstet. 2009 May;105(2):103-4 - PubMed
  15. Eur J Gynaecol Oncol. 2009;30(3):255-8 - PubMed
  16. Int J Gynecol Cancer. 2009 Jan;19(1):94-102 - PubMed
  17. Int J Gynecol Pathol. 2006 Jul;25(3):216-22 - PubMed
  18. Lancet Oncol. 2009 Apr;10(4):351-69 - PubMed
  19. Gynecol Oncol. 2009 Nov;115(2):199-203 - PubMed
  20. Am J Obstet Gynecol. 2008 Sep;199(3):244.e1-7 - PubMed
  21. Gynecol Oncol. 2011 Jul;122(1):95-9 - PubMed
  22. J Clin Oncol. 2011 Mar 1;29(7):832-8 - PubMed
  23. BJOG. 2007 Oct;114(10 ):1188-90 - PubMed
  24. Gynecol Oncol. 2011 Oct;123(1):43-6 - PubMed
  25. J Obstet Gynaecol. 2011 Nov;31(8):754-8 - PubMed
  26. Gynecol Oncol. 2005 Dec;99(3):730-5 - PubMed
  27. BJOG. 2007 Oct;114(10 ):1183-5; discussion 1186-7 - PubMed
  28. Acta Obstet Gynecol Scand. 2011 Mar;90(3):273-9 - PubMed
  29. J Natl Cancer Inst. 2006 Feb 1;98(3):151-4 - PubMed
  30. Int J Gynecol Cancer. 2015 May;25(4):551-8 - PubMed
  31. BJOG. 2000 Sep;107(9):1061-3 - PubMed
  32. Gynecol Oncol. 2012 Aug;126(2):286-90 - PubMed
  33. Gynecol Oncol. 2009 Mar;112(3):455-61 - PubMed
  34. Can J Public Health. 2008 May-Jun;99(3):221-6 - PubMed
  35. Gynecol Oncol. 2009 Feb;112(2):422-36 - PubMed
  36. Can J Surg. 2008 Oct;51(5):346-54 - PubMed

Publication Types