Treatment patterns and associated factors in patients with advanced epithelial ovarian cancer: A population-based study

Myrte Zijlstra, Maite Timmermans, Heidi Fransen, Maaike Van Der Aa, An Reyners, Natasja Raijmakers, Lonneke Van De Poll-franse

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Objectives A significant proportion of women with advanced-stage ovarian cancer receive no cancer-directed treatment and limited research has been devoted to this group. This population-based study aimed to gain insight into treatment patterns and trends in patients with advanced epithelial ovarian cancer in the Netherlands and the main reasons for deciding for no cancer-directed treatment. Methods All patients diagnosed with advanced epithelial ovarian cancer, International Federation of Gynecology and Obstetrics (FIGO) classification IIB−IV, between 2008 and 2016 were identified from the Netherlands Cancer Registry. Trends in the number of patients receiving cancer-directed treatment were analyzed. Multivariable logistic regression analysis was used to identify factors associated with no cancer-directed treatment. The main reasons for no cancer-directed treatment were analyzed. Results A total of 9303 patients were included, of whom 14% (n=1270) received no cancer-directed treatment while 67% (n=6218) received a combination of cytoreductive surgery and chemotherapy. Some 15% (n=1399) received chemotherapy only, and 4.5% (n=416) surgical resection or hormonal therapy only. The proportion of patients receiving no cancer-directed treatment was higher in 2014–2016 (16%, n=496/3175) compared with 2008–2010 (11%, n=349/3057, p<0.001). Associated factors with no cancer-directed treatment were higher age, FIGO stage IV, lower socioeconomic status, co-morbidity, and more recent years of diagnosis (p<0.001). Main reasons for no cancer-directed treatment were patient’s choice (40%) and poor condition of the patient (29%). Conclusions The proportion of patients with advanced epithelial ovarian cancer not receiving cancer-directed treatment has increased in the last decade in the Netherlands. Patient’s choice was the main reason for the decision to undergo no cancer-directed treatment, which indicates patient involvement in the decision-making process. The second most common reason for no cancer-directed treatment was poor condition of the patient, which might indicate careful selection of patients for treatment. Decision-making regarding treatment is well-considered, but more insight is needed, especially from the patient's perspective.
Original languageEnglish
Pages (from-to)1032-1037
JournalInternational Journal of Gynecological Cancer
Volume29
Issue number6
DOIs
Publication statusPublished - 2019

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Neoplasms
Netherlands
Gynecology
Obstetrics
Patient Participation
Ovarian Neoplasms
Patient Selection
Logistic Models

Keywords

  • CARE
  • GYNECOLOGIC ONCOLOGISTS
  • IMPROVEMENT
  • LIFE
  • OUTCOMES
  • PREVALENCE
  • SURVIVAL
  • TREATMENT DECISION-MAKING
  • TRENDS
  • WOMEN
  • medical oncology
  • ovarian neoplasms
  • palliative care
  • quality of life (pro)
  • surgical oncology

Cite this

Zijlstra, Myrte ; Timmermans, Maite ; Fransen, Heidi ; Van Der Aa, Maaike ; Reyners, An ; Raijmakers, Natasja ; Van De Poll-franse, Lonneke. / Treatment patterns and associated factors in patients with advanced epithelial ovarian cancer : A population-based study. In: International Journal of Gynecological Cancer. 2019 ; Vol. 29, No. 6. pp. 1032-1037.
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title = "Treatment patterns and associated factors in patients with advanced epithelial ovarian cancer: A population-based study",
abstract = "Objectives A significant proportion of women with advanced-stage ovarian cancer receive no cancer-directed treatment and limited research has been devoted to this group. This population-based study aimed to gain insight into treatment patterns and trends in patients with advanced epithelial ovarian cancer in the Netherlands and the main reasons for deciding for no cancer-directed treatment. Methods All patients diagnosed with advanced epithelial ovarian cancer, International Federation of Gynecology and Obstetrics (FIGO) classification IIB−IV, between 2008 and 2016 were identified from the Netherlands Cancer Registry. Trends in the number of patients receiving cancer-directed treatment were analyzed. Multivariable logistic regression analysis was used to identify factors associated with no cancer-directed treatment. The main reasons for no cancer-directed treatment were analyzed. Results A total of 9303 patients were included, of whom 14{\%} (n=1270) received no cancer-directed treatment while 67{\%} (n=6218) received a combination of cytoreductive surgery and chemotherapy. Some 15{\%} (n=1399) received chemotherapy only, and 4.5{\%} (n=416) surgical resection or hormonal therapy only. The proportion of patients receiving no cancer-directed treatment was higher in 2014–2016 (16{\%}, n=496/3175) compared with 2008–2010 (11{\%}, n=349/3057, p<0.001). Associated factors with no cancer-directed treatment were higher age, FIGO stage IV, lower socioeconomic status, co-morbidity, and more recent years of diagnosis (p<0.001). Main reasons for no cancer-directed treatment were patient’s choice (40{\%}) and poor condition of the patient (29{\%}). Conclusions The proportion of patients with advanced epithelial ovarian cancer not receiving cancer-directed treatment has increased in the last decade in the Netherlands. Patient’s choice was the main reason for the decision to undergo no cancer-directed treatment, which indicates patient involvement in the decision-making process. The second most common reason for no cancer-directed treatment was poor condition of the patient, which might indicate careful selection of patients for treatment. Decision-making regarding treatment is well-considered, but more insight is needed, especially from the patient's perspective.",
keywords = "CARE, GYNECOLOGIC ONCOLOGISTS, IMPROVEMENT, LIFE, OUTCOMES, PREVALENCE, SURVIVAL, TREATMENT DECISION-MAKING, TRENDS, WOMEN, medical oncology, ovarian neoplasms, palliative care, quality of life (pro), surgical oncology",
author = "Myrte Zijlstra and Maite Timmermans and Heidi Fransen and {Van Der Aa}, Maaike and An Reyners and Natasja Raijmakers and {Van De Poll-franse}, Lonneke",
year = "2019",
doi = "10.1136/ijgc-2019-000489",
language = "English",
volume = "29",
pages = "1032--1037",
journal = "International Journal of Gynecological Cancer",
issn = "1048-891X",
publisher = "Lippincott Williams and Wilkins",
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}

Treatment patterns and associated factors in patients with advanced epithelial ovarian cancer : A population-based study. / Zijlstra, Myrte; Timmermans, Maite; Fransen, Heidi; Van Der Aa, Maaike; Reyners, An; Raijmakers, Natasja; Van De Poll-franse, Lonneke.

In: International Journal of Gynecological Cancer, Vol. 29, No. 6, 2019, p. 1032-1037.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Treatment patterns and associated factors in patients with advanced epithelial ovarian cancer

T2 - A population-based study

AU - Zijlstra, Myrte

AU - Timmermans, Maite

AU - Fransen, Heidi

AU - Van Der Aa, Maaike

AU - Reyners, An

AU - Raijmakers, Natasja

AU - Van De Poll-franse, Lonneke

PY - 2019

Y1 - 2019

N2 - Objectives A significant proportion of women with advanced-stage ovarian cancer receive no cancer-directed treatment and limited research has been devoted to this group. This population-based study aimed to gain insight into treatment patterns and trends in patients with advanced epithelial ovarian cancer in the Netherlands and the main reasons for deciding for no cancer-directed treatment. Methods All patients diagnosed with advanced epithelial ovarian cancer, International Federation of Gynecology and Obstetrics (FIGO) classification IIB−IV, between 2008 and 2016 were identified from the Netherlands Cancer Registry. Trends in the number of patients receiving cancer-directed treatment were analyzed. Multivariable logistic regression analysis was used to identify factors associated with no cancer-directed treatment. The main reasons for no cancer-directed treatment were analyzed. Results A total of 9303 patients were included, of whom 14% (n=1270) received no cancer-directed treatment while 67% (n=6218) received a combination of cytoreductive surgery and chemotherapy. Some 15% (n=1399) received chemotherapy only, and 4.5% (n=416) surgical resection or hormonal therapy only. The proportion of patients receiving no cancer-directed treatment was higher in 2014–2016 (16%, n=496/3175) compared with 2008–2010 (11%, n=349/3057, p<0.001). Associated factors with no cancer-directed treatment were higher age, FIGO stage IV, lower socioeconomic status, co-morbidity, and more recent years of diagnosis (p<0.001). Main reasons for no cancer-directed treatment were patient’s choice (40%) and poor condition of the patient (29%). Conclusions The proportion of patients with advanced epithelial ovarian cancer not receiving cancer-directed treatment has increased in the last decade in the Netherlands. Patient’s choice was the main reason for the decision to undergo no cancer-directed treatment, which indicates patient involvement in the decision-making process. The second most common reason for no cancer-directed treatment was poor condition of the patient, which might indicate careful selection of patients for treatment. Decision-making regarding treatment is well-considered, but more insight is needed, especially from the patient's perspective.

AB - Objectives A significant proportion of women with advanced-stage ovarian cancer receive no cancer-directed treatment and limited research has been devoted to this group. This population-based study aimed to gain insight into treatment patterns and trends in patients with advanced epithelial ovarian cancer in the Netherlands and the main reasons for deciding for no cancer-directed treatment. Methods All patients diagnosed with advanced epithelial ovarian cancer, International Federation of Gynecology and Obstetrics (FIGO) classification IIB−IV, between 2008 and 2016 were identified from the Netherlands Cancer Registry. Trends in the number of patients receiving cancer-directed treatment were analyzed. Multivariable logistic regression analysis was used to identify factors associated with no cancer-directed treatment. The main reasons for no cancer-directed treatment were analyzed. Results A total of 9303 patients were included, of whom 14% (n=1270) received no cancer-directed treatment while 67% (n=6218) received a combination of cytoreductive surgery and chemotherapy. Some 15% (n=1399) received chemotherapy only, and 4.5% (n=416) surgical resection or hormonal therapy only. The proportion of patients receiving no cancer-directed treatment was higher in 2014–2016 (16%, n=496/3175) compared with 2008–2010 (11%, n=349/3057, p<0.001). Associated factors with no cancer-directed treatment were higher age, FIGO stage IV, lower socioeconomic status, co-morbidity, and more recent years of diagnosis (p<0.001). Main reasons for no cancer-directed treatment were patient’s choice (40%) and poor condition of the patient (29%). Conclusions The proportion of patients with advanced epithelial ovarian cancer not receiving cancer-directed treatment has increased in the last decade in the Netherlands. Patient’s choice was the main reason for the decision to undergo no cancer-directed treatment, which indicates patient involvement in the decision-making process. The second most common reason for no cancer-directed treatment was poor condition of the patient, which might indicate careful selection of patients for treatment. Decision-making regarding treatment is well-considered, but more insight is needed, especially from the patient's perspective.

KW - CARE

KW - GYNECOLOGIC ONCOLOGISTS

KW - IMPROVEMENT

KW - LIFE

KW - OUTCOMES

KW - PREVALENCE

KW - SURVIVAL

KW - TREATMENT DECISION-MAKING

KW - TRENDS

KW - WOMEN

KW - medical oncology

KW - ovarian neoplasms

KW - palliative care

KW - quality of life (pro)

KW - surgical oncology

U2 - 10.1136/ijgc-2019-000489

DO - 10.1136/ijgc-2019-000489

M3 - Article

VL - 29

SP - 1032

EP - 1037

JO - International Journal of Gynecological Cancer

JF - International Journal of Gynecological Cancer

SN - 1048-891X

IS - 6

ER -