Charlotte Palmqvist - Centralized Ovarian Cancer Care - Complications, Costs and Survival
On May 13, Charlotte Palmqvist defended her thesis for Doctor of Medical 91̽»¨ at the Institute of Clinical 91̽»¨s, Sahlgrenska Academy, in the research subject of obstetrics and gynecology.
The title of the thesis is: Centralized Ovarian Cancer Care - Complications, Costs and Survival
Background: Ovarian cancer is often diagnosed at advanced stages, and its mortality is high. Surgical treatment of advanced ovarian cancer strives toward complex primary debulking surgery (PDS), aiming for complete cytoreduction (R0) and improved survival. With more complex surgery, complications may increase and affect the crucial adjuvant chemotherapy, which is aimed to start within 21 days. New treatment strategies may cause health care costs to rise, although the cost of illness may fall due to lower costs of production loss.
Aim: The overall aim of this thesis was to explore survival, surgical complications, and costs in a population-based cohort in which ovarian cancer care has been centralized.
Most women are diagnosed at an advanced stage, and stage is the strongest predictor of survival. (see Figure 1 below).
Conclusions: Survival increased after the centralization of primary care for advanced ovarian cancer. Complex surgery is associated with severe complications, but these complications do not affect the completion of adjuvant chemotherapy. The societal cost of ovarian cancer may fall with treatments that prolong survival and cost-of-illness studies needs to be incorporated in the analysis of major organisation and treatment changes.
Supervisor: Pernilla Dahm-Kähler
Co-Supervisor: Mia Johansson och Per Albertsson
Opponent: Christina Fotopoulou, Imperial College, London, UK
Examining Committee: Andreas Muth, Ulrika Smed och Hanna Dahlstrand