Impact of provider imaging practices on survival outcomes in advanced ovarian cancer Journal Article


Authors: Green, A. K.; Korenstein, D.; Aghajanian, C.; Barrow, B.; Curry, M.; O'Cearbhaill, R. E.
Article Title: Impact of provider imaging practices on survival outcomes in advanced ovarian cancer
Abstract: BACKGROUND: This study sought to describe how high- versus low-frequency surveillance imaging practices among providers at Memorial Sloan Kettering Cancer Center (MSKCC) impact overall survival (OS) and time to recurrence of patients with advanced epithelial ovarian cancer in first remission. METHODS: The study cohort included patients with stage II-IV high-grade epithelial ovarian cancer diagnosed in January 2001 through January 2017 who experienced recurrence after initial platinum-based chemotherapy. To determine usual imaging practices for providers at MSKCC, median frequency of CT or MRI of the abdomen/pelvis was calculated among patients with a long-term remission (defined as at least 1 year) treated by each provider. Cox proportional hazards models were used to examine differences in OS and time to recurrence among patients treated by providers with high versus low imaging frequency practices, with additional subgroup analysis among patients with elevated CA-125 levels >35 U/mL at diagnosis. Chi-square tests were used to examine differences in the proportion of patients who enrolled in clinical trials or underwent secondary cytoreductive surgery (SCS) by imaging frequency. RESULTS: A total of 543 patients were treated by providers with high imaging frequency (>1 scan every 12 months) and 141 were treated by providers with low imaging frequency (≤1 scan every 12 months). Time to recurrence was shorter among patients treated by providers with high versus low imaging frequency (18.0 vs 19.2 months; hazard ratio, 1.33; P=.003). Results were similar when restricted to patients with elevated CA-125 levels at diagnosis. There was no significant difference in OS, clinical trial enrollment, or SCS by imaging practice. CONCLUSIONS: Within the limitations of this retrospective analysis, patients with advanced ovarian cancer treated by high-frequency-imaging providers had earlier detection of recurrence. Future analyses in a larger population are warranted to elucidate the risks versus benefits of surveillance imaging.
Journal Title: Journal of the National Comprehensive Cancer Network
Volume: 18
Issue: 4
ISSN: 1540-1405
Publisher: Harborside Press  
Date Published: 2020-04-01
Start Page: 414
End Page: 419
Language: English
DOI: 10.6004/jnccn.2019.7376
PUBMED: 32259789
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 1 May 2020 -- Source: Scopus
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MSK Authors
  1. Angela Kellen Green
    8 Green
  2. Brooke Barrow
    3 Barrow
  3. Michael A Curry
    5 Curry