title: Discordance between beliefs and recommendations of gynecologic oncologists in ovarian cancer management.
abstract: OBJECTIVE
  The purpose of this study was to determine how physician experts make decisions for clinical scenarios in ovarian cancer and describe a profile of factors reported to influence treatment decisions.
  
  
  METHODS
  A questionnaire was sent to Full Members of the Society of Gynecologic Oncologists regarding surgery and chemotherapy for scenarios of primary and recurrent ovarian cancer.
  
  
  RESULTS
  In a scenario of primary presentation, 94% of respondents chose a treatment of tumor resection over chemotherapy. Despite the preference for surgery in a clinical scenario, 50% agreed with a statement that neoadjuvant chemotherapy is equivalent to primary surgery. In a scenario of recurrent disease, a comparable number of respondents chose a treatment of secondary cytoreductive surgery (45%) versus direct retreatment with chemotherapy (49%). Those choosing surgery responded that they believed in extensive surgery to achieve optimal cytoreduction. Most (62%) respondents described themselves as collaborative in treatment planning, yet only 24% reported that patient preference strongly influences their decision making.
  
  
  CONCLUSIONS
  Although a plan for primary cytoreduction is favored, in specific scenarios, views were divided for the role of neoadjuvant chemotherapy. For a recurrent disease scenario, support was divided between secondary cytoreductive surgery and direct retreatment with chemotherapy. Further clinical research is necessary to minimize the discordance between physician beliefs and recommendations.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco Comprehensive Cancer Center, San Francisco, CA 94143-1702, USA. lee-may.chen@ucsfmedctr.org
authors.forename: L
authors.initials: L
authors.lastname: Chen
authors.forename: L A
authors.initials: LA
authors.lastname: Learman
authors.forename: V
authors.initials: V
authors.lastname: Weinberg
authors.forename: C B
authors.initials: CB
authors.lastname: Powell
mesh_terms: D003131:Combined Modality Therapy; D003657:Decision Making; D005260:Female; D006176:Gynecology / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000379:methods* / Q000706:statistics & numerical data; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000628:therapy*; D010347:Patient Care Planning; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology