Cancer Research, Statistics, and Treatment (Jan 2019)
Ovarian cancer practice survey from the South Asian Association for Regional Cooperation (SAARC) Nations
Abstract
Background: Management of ovarian cancer has evolved over time with innovations in surgical management as well as in systemic therapy. In the real world, treatment is often adapted to distinct settings based on the socioeconomic factors, physician and patient preference, availability of resources, need for referral, and controversies in the standard treatment. These deviations from conventional treatment can lead to suboptimal results and a better comprehension of this variability can help us to plan corrective measures for improvement in community practice. Methods: The survey instrument consisted of four sections dealing with baseline details of participants, early-stage ovarian cancer practice patterns, surgical practice patterns, and adjuvant/neoadjuvant chemotherapy (NACT) in advanced-stage ovarian cancer. It was an anonymous survey sent as an email and the responses were electronically captured. No incentive was provided. Descriptive statistics were performed using the SPSS software version 20 and R studio. Results: Seventy-five of 258 participants responded. Majority of participants (n = 67, 89.3%) were in favor of doing a fertility-preserving surgery in early-stage ovarian cancer with 86.7% opting for open surgery (n = 65) and only 13.3% (n = 10) using minimally invasive methods. The proportions of early-stage ovarian cancer patients receiving chemotherapy were> 90% in 14.7% (n = 11), 75%–90% in 24% (n = 18), 50%–75% in 18.7% (n = 14), 10%–50% in 32% (n = 24), and <10% in 10.7% (n = 8). In the advanced stage, few centers had high rates of microscopically margin negative (R0) resection with primary cytoreduction. About 90.7% of participants (n = 68) avoided doing multiorgan resection for achieving an R0 resection. Sixty percent (n = 45) of the 75 participants offered NACT to all Stage III–IV patients. Conclusion: Ovarian cancer management in the South Asian Association for Regional Cooperation countries is largely congruent with international guidelines. Differences in the administration of intensive chemotherapy schedules and targeted therapy are observed.
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