Standard of care not routinely used in Medicare beneficiaries with advanced ovarian cancer

42nd Annual Meeting of the Society for Gynecologic Oncologists

ORLANDO — Less than 40% of patients on Medicare received the standard care for advanced ovarian cancer, according to researchers from the University of Washington Medical Center in Seattle.

Melissa Thrall, MD, and colleagues also found a decrease in the use of primary debulking surgery as the primary treatment for advanced ovarian cancer among women covered by Medicare, according to the data, which were obtained from the SEER database and from Medicare claims.

For advanced ovarian cancer, the standard care consists of primary debulking surgery followed by at least six cycles of platinum-based chemotherapy. However, in the large US-population-based study, only 39.1% of the 8,211 women received the surgery combined with the chemotherapy.

“In 1994, the National Institutes of Health issued a consensus statement indicating that the appropriate treatment for advanced ovarian cancer is surgery followed by systemic chemotherapy,” Thrall said. “These treatment recommendations were also reflected in the National Comprehensive Cancer Network guidelines.”

Of the 8,211 women who were included in the study, 4,827 of the patients received the primary debulking surgery, but of these, only 2,669 received the recommended six cycles of postoperative chemotherapy. In 2,017 women, chemotherapy was the primary treatment, and of those, only 649 later had the surgery. The remaining women continued receiving chemotherapy and a palliative treatment. About 17% of the patients in the study had no evidence of either surgery or chemotherapy.

The data also identified factors that correlated with each treatment type. Women who were aged 80 years and older were more likely to be treated primarily with chemotherapy, as were women with stage IV tumors. Women who received no treatment were more likely to be of a non-white race, be unmarried and have a lower median household income.

For more information:

Thrall M. #2. Presented at: 42^nd Annual Meeting of the Society of Gynecologic Oncologists. March 6-9, 2011; Orlando, Fla.

Disclosures: The researchers report no relevant financial disclosures.

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