Evaluation of Society of Gynecologic Oncologists (SGO) ovarian cancer quality surgical measures.

OBJECTIVES

The Society of Gynecologic Oncologists has developed two measures to assess and improve the surgical care of patients with ovarian cancer (1) description of residual disease following cytoreduction and (2) adequacy of surgical staging. Our aim was to establish baseline surgeon compliance with these two measures.

METHODS

A retrospective review of patients with ovarian, fallopian tube or peritoneal cancer undergoing surgery between 7/1/2006 and 7/1/2011 for the purposes of staging and/or cytoreduction was performed at the University of Washington and Geisinger Medical Center. Operative and pathology reports were reviewed to obtain information pertaining to stage, histology, residual disease after surgery and the extent of surgical staging.

RESULTS

537 cases were identified; 91% with ovarian cancer. 61% of patients had at least stage IIIC disease; 15% had recurrent disease and 16% had neoadjuvant therapy. For patients with stages I-IIIB disease, 74% had full surgical staging, 10% did not have full surgical staging but documented the reason for this in the operative report; 15% did not have full surgical staging, no reason was noted. 25% of all operative reports lacked documentation of residual disease with 40% documenting no gross residual disease, 18% with residual disease <1cm and 18% had suboptimal debulking with >1 cm disease remaining. There was a statistically significant increase in appropriate documentation of amount of residual disease over time (p<0.001).

CONCLUSIONS

Our study sets benchmarks for evaluation of documentation in gynecologic oncology centers. Improved documentation and staging will allow for equivalent standards of care across institutions.