title: Clinical governance network for clinical audit to improve quality in epithelial ovarian cancer management.
abstract: BACKGROUND
  Epithelial ovarian cancer (EOC) is the most lethal gynecological cancer. Several hospitals throughout the region provide primary treatment for these patients and it is well know that treatment quality is correlated to the hospital that delivers. The aim of this study was to investigate the management and treatment of EOC in a Region of the North Italy (Emilia-Romagna, Italy).
  
  
  METHODS
  A multidisciplinary group made up of 11 physicians and 3 biostatisticians was formed in 2009 to perform clinical audits in order to identify quality indicators and to develop Region-wide workup in accordance with the principles of evidence-based medicine (EBM). The rationale was that, by setting up an oncogynecology network so as to achieve the best clinical practice, critical points would decrease or even be eliminated. Analysis of cases was based on the review of the medical records.
  
  
  RESULTS
  614 EOC patients treated between 2007 and 2008 were identified. We found only 2 high-volume hospitals (≥ 21 patients/year), 3 medium-volume hospitals (11-20 operated patients/year), and 7 low-volume hospitals (≤ 10 operated patients /year). Only 222 patients (76.3%) had a histological diagnosis, FIGO surgical staging was reported only in 206 patients (70.9%) but not all standard surgical procedures were always performed, residual disease were not reported in all patients. No standard number of neoadjuvant chemotherapy cycles was observed.
  
  
  CONCLUSIONS
  The differences in terms of treatments provided led the multidisciplinary group to identify reference centers, to promote centralization, to ensure uniform and adequate treatment to patients treated in regional centers and to promote a new audit involving all regional hospitals to a complete review of the all the EOC patients.
authors.affiliation: Department of Obstetrics and Gynecology, Arcispedale S, Maria Nuova- IRCCS, Reggio Emilia, Italy. dariomandato@virgilio.it.
authors.forename: Vincenzo Dario
authors.initials: VD
authors.lastname: Mandato
authors.forename: Martino
authors.initials: M
authors.lastname: Abrate
authors.forename: Pierandrea
authors.initials: P
authors.lastname: De Iaco
authors.forename: Debora
authors.initials: D
authors.lastname: Pirillo
authors.forename: Gino
authors.initials: G
authors.lastname: Ciarlini
authors.forename: Maurizio
authors.initials: M
authors.lastname: Leoni
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Comerci
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ventura
authors.forename: Bruno
authors.initials: B
authors.lastname: Lenzi
authors.forename: Andrea
authors.initials: A
authors.lastname: Amadori
authors.forename: Federica
authors.initials: F
authors.lastname: Rosati
authors.forename: Ruby
authors.initials: R
authors.lastname: Martinello
authors.forename: Rossana
authors.initials: R
authors.lastname: De Palma
authors.forename: Chiara
authors.initials: C
authors.lastname: Ventura
authors.forename: Laura Maria Beatrice
authors.initials: LM
authors.lastname: Belotti
authors.forename: Debora
authors.initials: D
authors.lastname: Formisano
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: La Sala
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