Current South African clinical Practice in Debulking Surgery for Ovarian Cancer

Billson, Jana; Merwe, F. Haynes van der; Soeters, Robbert

doi:10.1097/igc.0000000000000789

Cited by 4 publications

(3 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…First, we needed to identify which QIs have clinical relevance in AOCS. Therefore, we performed a systematic search on clinical practice guidelines [5][6][7], consensus conferences [8], and reviews on the outcomes and quality of AOCS [9][10][11][12][13][14][15] that were published in MEDLINE/ PubMed, Embase, and the Cochrane Library.…”

Section: Search Strategymentioning

confidence: 99%

Outcome quality standards in advanced ovarian cancer surgery

et al. 2020

View full text Add to dashboard Cite

Introduction Advanced ovarian cancer surgery (AOCS) frequently results in serious postoperative complications. Because managing AOCS is difficult, some standards need to be established that allow surgeons to assess the quality of treatment provided and consider what aspects should improve. This study aimed to identify quality indicators (QIs) of clinical relevance and to establish their acceptable quality limits (i.e., standard) in AOCS. Materials and methods We performed a systematic search on clinical practice guidelines, consensus conferences, and reviews on the outcome and quality of AOCS to identify which QIs have clinical relevance in AOCS. We then searched the literature (from January 2006 to December 2018) for each QI in combination with the keywords of advanced ovarian cancer, surgery, outcome, and oncology. Standards for each QI were determined by statistical process control techniques. The acceptable quality limits for each QI were defined as being within the limits of the 99.8% interval, which indicated a favorable outcome. Results A total of 38 studies were included. The QIs selected for AOCS were complete removal of the tumor upon visual inspection (complete cytoreductive surgery), a residual tumor of < 1 cm (optimal cytoreductive surgery), a residual tumor of > 1 cm (suboptimal cytoreductive surgery), major morbidity, and 5-year survival. The rates of complete cytoreductive surgery, optimal cytoreductive surgery, suboptimal cytoreductive surgery, morbidity, and 5-year survival had quality limits of < 27%, < 23%, > 39%, > 33%, and < 27%, respectively. Conclusion Our results provide a general view of clinical indicators for AOCS. Acceptable quality limits that can be considered as standards were established.

show abstract

Section: Search Strategymentioning

confidence: 99%

Outcome quality standards in advanced ovarian cancer surgery

et al. 2020

View full text Add to dashboard Cite

show abstract

“…A similar study conducted in South Africa by Billson et al 53 also listed ICU bed availability as a major barrier to the adoption of cytoreductive procedures, alongside lack of perioperative expertise and qualified surgeons in less populous areas. Paulino et al 52 discussed barriers to debulking surgery in Latin America within the context of ovarian cancer.…”

Section: Global Trends In the Adoption Of Crsmentioning

confidence: 94%

Adoption of cytoreductive surgery in the management of peritoneal malignancies—Global trends

Sedighim,

Khan,

et al. 2023

Journal of Surgical Oncology

View full text Add to dashboard Cite

Cytoreductive surgery (CRS) has now been accepted as an integral component in the management of gastrointestinal and gynecological cancers with peritoneal metastases. Since the adoption of CRS is influenced by access to advanced medical facilities, trained multidisciplinary teams, and funding, there is wide variability in incorporation of CRS into routine clinical practice between high‐ versus low‐ and middle‐income countries. This review highlights the global trends in the adoption of CRS for peritoneal malignancies with a specific focus on the establishment of CRS programs and barriers to incorporate CRS into routine clinical care in low‐ and middle‐income countries.

show abstract

“…3,4 Neoadjuvant chemotherapy (NACT) has been gaining greater acceptance in the past decade for patients with advanced disease, 5 and given the barriers that many countries face in successfully pursuing upfront surgery, upfront debulking surgery might not be performed frequently or properly. 6,7 This might especially be true in lowand middle-income countries, where paucity of physical and human resources and lack of proper training and knowledge about the disease negatively impact patient outcomes.…”

mentioning

confidence: 99%

Barriers to Primary Debulking Surgery for Advanced Ovarian Cancer in Latin America

Paulino

Rodrigues

Strasser‐Weippl

et al. 2017

International Journal of Gynecological Cancer

View full text Add to dashboard Cite

Ovarian cancer is gynecologic tumor with particularly high mortality because it is usually diagnosed in advanced stages. In Latin America and the Caribbean, it is the eighth most common malignancy in women, with an estimated 18,000 new cases and 11,500 deaths annually. Standard of care for women diagnosed with advanced ovarian cancer (AOC) is primary cytoreductive surgery followed by systemic chemotherapy using a combination of paclitaxel plus carboplatin. To pursue upfront surgery, highly specialized and well-trained gynecologic oncologists are required, in addition with well-equipped hospitals. Neoadjuvant chemotherapy (NACT) has been gaining greater acceptance in the past decade for patients with AOC. Two phase III randomized clinical trials have demonstrated that NACT is noninferior to primary cytoreductive surgery for women with stages III and IV epithelial ovarian cancer, and since publication of these results, NACT is more commonly used. Apart from medical reasons of inoperability and unresectability, there may be nonmedical barriers to upfront debulking surgery in clinical practice. These barriers include inadequate expertise of the surgeon, inadequate resources, and/or barriers to access. The aim of this article was to discuss patterns of care and barriers to upfront ovarian debulking surgery, as well as a possible shift toward overuse of NACT as the primary approach for patients with AOC (stages III and IV) in Latin America.

show abstract

Current South African clinical Practice in Debulking Surgery for Ovarian Cancer

Abstract: The progression of South African Gynaecological Oncologist towards more aggressive debulking surgery is following international trends, but many of the surgeons report a lack of experience in ultra-radical debulking surgery, especially in the upper abdomen.

Cited by 4 publications

References 28 publications

Outcome quality standards in advanced ovarian cancer surgery

Outcome quality standards in advanced ovarian cancer surgery

Adoption of cytoreductive surgery in the management of peritoneal malignancies—Global trends

Barriers to Primary Debulking Surgery for Advanced Ovarian Cancer in Latin America

Contact Info

Product

Resources

About