Relation between the number of board-certified gynecologic oncologists per hospital and survival of cervical cancer

J Obstet Gynaecol Res. 2019 Jun;45(6):1160-1166. doi: 10.1111/jog.13948. Epub 2019 Mar 6.

Abstract

Aims: In cancer therapy, choice of treatment method has a tremendous influence on patient prognosis. We aimed to evaluate the impact of the number of Gynecologic Oncology (GO) Specialists on treatment outcomes of cervical cancer patients.

Methods: We used data for 5-year treatment outcomes obtained from the annual treatment reports of the Gynecologic Oncology Committee of Japan Society of Obstetrics and Gynecology (JSOG). We compared this to data posted on the Japanese Society of Gynecologic Oncology (JSGO) website regarding the enrollment of GO Specialists at each hospital.

Results: The 5-year survival ratio of cervical cancer patients treated in hospitals with 2-or-more GO Specialists was 79.0% (2010/2543). This was significantly higher than 75.4% (974/1292) for facilities with 0 or 1 specialist (P = 0.011); however, the number of GO Specialists was not an independent prognostic factor (P = 0.77, adjusted HR: 1.13 [0.38-2.03]). The 5-year survival ratio significantly increased in medical facilities whose number of GO Specialists increased from 0 to 1 or more, or from 1 to 2 or more (P = 0.045).

Conclusion: This study demonstrates a causal relationship between the numbers of GO Specialists and treatment outcomes of cervical cancer patients for the first time. Our study suggests that although JSGO board-certified gynecologic oncologists do clearly contribute to improving treatment outcome, the number of specialists was not an independent factor for improving the prognosis of the patients. Thus, it was not clear whether simply increasing the number of GO Specialists, beyond two, will lead to any significant improvement in cervical cancer patient prognosis.

Keywords: board-certified gynecologic oncologist; cervical cancer; hospital; number; survival ratio.

MeSH terms

  • Adult
  • Female
  • Gynecology / legislation & jurisprudence
  • Gynecology / statistics & numerical data*
  • Hospitals / statistics & numerical data*
  • Humans
  • Japan
  • Oncologists / legislation & jurisprudence
  • Oncologists / statistics & numerical data*
  • Outcome Assessment, Health Care / statistics & numerical data*
  • Specialty Boards / legislation & jurisprudence
  • Specialty Boards / statistics & numerical data
  • Survival Analysis
  • Survival Rate
  • Uterine Cervical Neoplasms / mortality*
  • Uterine Cervical Neoplasms / therapy*