Page 3 - Ovarian Cancer Surgery - Quality Indicators
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1 Introduction
Ovarian cancer is the leading cause of death among all gynecologic cancers and remains the most common cause
of death for 15 years after diagnosis in women with stage III-IV tumours1,2. Surgery is the cornerstone in
treatment of advanced ovarian cancer. Quality of surgical care as a component of a comprehensive regimen of
multidisciplinary management has been shown to benefit the patient in other types of malignancies.
Implementation of a quality improvement programme helped to reduce both morbidity and costs in other
tumours where surgical interventions are also high risk. A mere implementation of a quality management
programme could impact survival of patients with advanced ovarian cancer3,4.
The European Society of Gynaecological Oncology ESGO) took a position to promote the training of
gynaecological surgeons treating cancer for abdominal procedures including colorectal resection and upper
abdominal surgery5. The aim of this project is to develop a list of quality indicators QIs for advanced ovarian
cancer surgery that can be used to audit and improve the clinical practice in an easy and practical way. These QIs
give practitioners and health administrators a quantitative basis for improving care and organizational processes.
They also facilitate the documentation of quality of care, the comparison of performance structures, and the
establishment of organizational priorities as a basis for accreditation.
The QIs and proposed targets are based on the standards of practice determined from scientific evidence and/or
expert consensus. The key characteristics of an ideal indicator are clear definition, clinical relevance,
measurability, feasibility in clinical practice, and a scientific basis. These QIs may have to be modified in the
future.
The philosophy behind the project is to improve the average standard of surgical care by providing a set of
quality criteria which can be used for self-assessment, for institutional quality assurance programs, for
governmental quality assessment, and eventually to build a network of certified centres for ovarian cancer
surgery. The mindset is not punitive but incentive. Certified centers can make the award known from doctors,
patients, patient advocacy groups and lay persons. On the contrary, the targets defined by the workgroup can
absolutely not be used to penalize or litigate doctors or institutions.
2 Acknowledgements
ESGO would like to thank the international development group for their constant availability, work, and for
making possible the development of these QIs for the advanced ovarian cancer surgery. ESGO is also very
grateful to the external panel of physicians and patients international reviewers for their participation. The
names of the participants in each group are listed on Appendix 1.
ESGO also wishes to express sincere gratitude to the Institut National du Cancer INCa, France for providing
the main funding for this work.
OVARIAN CANCER SURGERY - QUALITY INDICATORS
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