Effect of quality control program on surgical management in advanced ovarian cancer.

IF 3.4 2区医学 Q1 OBSTETRICS & GYNECOLOGY Journal of Gynecologic Oncology Pub Date : 2024-07-05 DOI:10.3802/jgo.2025.36.e21

Bo Ra Kim, Hyejin Ko, Dahye Son, Ji Eun Shim, Yun Hwan Kim

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Abstract

Objective: We investigated the effect of our quality control (QC) program on the management strategy, completeness of the surgery, and clinical outcomes in advanced ovarian cancer.

Methods: A retrospective review of medical records from January 2005 to December 2019 identified 129 patients with advanced ovarian cancer. Cases were categorized into group 1 (2005-2013) and group 2 (2014-2019) before and after implementation of the QC program. Comparisons included clinicopathological variables, operative details, recurrence and survival outcomes.

Results: In Group 2 (n=44), after QC program implementation, primary debulking surgery (PDS) decreased (87.1% vs. 63.6%) and interval debulking surgery (IDS) increased (12.9% vs. 36.4%), indicating a shift in surgical strategy. Optimal resection rates improved significantly for PDS in group 2 (50.0% to 75.0%, p=0.007) and remained high for IDS in both groups (81.8% vs. 81.3%, p>0.999). Post-QC, advanced debulking procedures and co-operation with other departments increased in the IDS (p<0.05). Intra/post-operative complication rates were statistically comparable (p>0.05), whereas postoperative hospital stay was significantly shorter in group 2 (17 days vs. 22 days, p=0.001). Median recurrence-free survival increased after QC, although not statistically significant (19.18 months vs. 25.38 months, p=0.855).

Conclusion: With QC program, treatment strategies and clinical outcomes were significantly improved in advanced ovarian cancer. Systematic QC monitoring program should be considered as routine surveillance for better surgical outcomes.

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质量控制计划对晚期卵巢癌手术治疗的影响。

目的我们研究了我们的质量控制（QC）计划对晚期卵巢癌的管理策略、手术完整性和临床结果的影响：通过对 2005 年 1 月至 2019 年 12 月的病历进行回顾性分析，确定了 129 例晚期卵巢癌患者。病例在实施质量控制计划前后分为第一组（2005-2013 年）和第二组（2014-2019 年）。比较内容包括临床病理变量、手术细节、复发和生存结果：在第2组（44人）中，实施QC计划后，主要切除手术（PDS）减少（87.1%对63.6%），间期切除手术（IDS）增加（12.9%对36.4%），表明手术策略发生了转变。第 2 组的 PDS 最佳切除率明显提高（从 50.0% 提高到 75.0%，P=0.007），而两组的 IDS 最佳切除率均保持在较高水平（81.8% 对 81.3%，P>0.999）。QC 后，IDS 的晚期清创手术和与其他部门的合作有所增加（P0.05），而术后住院时间在第 2 组明显缩短（17 天对 22 天，P=0.001）。QC后，无复发生存期中位数有所增加，但无统计学意义（19.18个月对25.38个月，P=0.855）：结论：实施质量控制项目后，晚期卵巢癌的治疗策略和临床疗效均有明显改善。为了获得更好的手术效果，应将系统的质量控制监测计划视为常规监测手段。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Gynecologic Oncology ONCOLOGY-OBSTETRICS & GYNECOLOGY

CiteScore

6.00

自引率

2.60%

发文量

审稿时长

>12 weeks

期刊介绍： The Journal of Gynecologic Oncology (JGO) is an official publication of the Asian Society of Gynecologic Oncology. Abbreviated title is ''J Gynecol Oncol''. It was launched in 1990. The JGO''s aim is to publish the highest quality manuscripts dedicated to the advancement of care of the patients with gynecologic cancer. It is an international peer-reviewed periodical journal that is published bimonthly (January, March, May, July, September, and November). Supplement numbers are at times published. The journal publishes editorials, original and review articles, correspondence, book review, etc.