Cross-sectional study of neoadjuvant chemotherapy, case volume, and mortality in advanced ovarian cancer

Death after cytoreductive surgery for advanced ovarian cancer is more frequent in low-volume hospitals than in high-volume hospitals. Neoadjuvant chemotherapy (NACT) has been shown to reduce surgical complications and surgical mortality without compromising oncologic outcomes. A cross-sectional study using the National Cancer Database found that among 70,707 patients with stage III or IV ovarian cancer, high utilization of NACT was associated with a 74% reduction in odds of 90-day mortality in high-volume centers, compared with 52% in low-volume centers. Treatment in high-volume centers with high (compared with low) NACT use was associated with a 4.1 month improvement in life expectancy. The authors conclude that treatment in high-volume centers with high NACT utilization was associated with improved outcomes among patients with advanced ovarian cancer.