Therapy of ovarian cancer (OC) in Germany – Treatment characteristics and survival results of the QS OVAR 2012

Introduction:

Quality of treatment in patients with OC is one of the main prognostic factors. The Qualitätssicherung Ovar (QS Ovar) was implemented as a nationwide initiative in 2000 in Germany and repeated about every 4 years.

Methods:

All hospitals in Germany were asked to document their patients anonymously with first diagnosis of OC in Q3/2012.

Results:

267 hospitals documented 940 pts (> 60% of all pts in Germany). Surgical staging according to guidelines was done in 69.6% of patients with early OC (FIGO I-IIA). There was a significant improvement (p < 0.001) compared to earlier years (e.g. 38.8% in 2004). Missing procedures were e.g. peritoneal biopsies (27.1%) and para-aortic lymphadenectomy (25.2%). 78.5% received the standard chemotherapy. 4 year overall survival (OS) in patients with standard therapy was 92.0% vs. 78.5% in patients not treated according to guidelines (p = 0.003). 77.2% were diagnosed at advanced FIGO stage IIB-IV. The rate of complete resection was 44.5%, which has also improved compared to earlier years (p = 0.004). 90.8% of the patients treated with chemotherapy received the recommended standard of at least carboplatin and paclitaxel. The 4 year OS rate of patients with complete resection and standard chemotherapy was 63.4% compared to 34.6% in patients with only one optimal treatment modality and 4.9% in patients with incomplete resection and a nonstandard systemic therapy (p < 0.001).

Conclusion:

The quality of treatment has improved. It shows a significant impact on further prognosis. Therefore, our aim should be the further improvement of surgical and medical treatment in Gynecologic Departments.