Discordance between beliefs and recommendations of gynecologic oncologists in ovarian cancer management.
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.
Chen
L
L
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
Learman
L A
LA
Weinberg
V
V
Powell
C B
CB
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