Improved outcomes due to changes in organization of care for patients with ovarian cancer in the Netherlands

F. A. Eggink, C. H. Mom, R. F. Kruitwagen, A. K. Reyners, W. J. Van Driel, L. F. Massuger, G. C. Niemeijer, A. G. Van der Zee, M. A. Van der Aa, H. W. Nijman*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Objectives. Objectives of this study were to evaluate the effect of changes in patterns of care, for example centralization and treatment sequence, on surgical outcome and survival in patients with epithelial ovarian cancer (EOC). Methods. Patients diagnosed with FIGO stage IIB-IV EOC (2004-2013) were selected from the Netherlands Cancer Registry. Primary outcomes were surgical outcome (extent of macroscopic residual tumor after surgery) and overall survival. Changes in treatment sequence (primary debulking surgery and adjuvant chemotherapy (PDS + ACT) or neo-adjuvant chemotherapy and interval debulking surgery (NACT + IDS)), hospital type and annual hospital volume were also evaluated. Results. Patient and tumor characteristics of 7987 patients were retrieved. Most patients were diagnosed with stage HI-IV EOC. The average annual case-load per hospital increased from 8 to 28. More patients received an optimal cytoreduction (tumor residue = 20 cytoreductive surgeries annually), 80% in medium (10-19 surgeries) and 71% in small hospitals (
Original languageEnglish
Pages (from-to)524-530
JournalGynecologic Oncology
Issue number3
Publication statusPublished - Jun 2016


  • Ovarian cancer
  • Pattern of care
  • Survival
  • Surgical outcome
  • Neo-adjuvant chemotherapy

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