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Variation in gynecological oncology follow-up practice: attributable to cancer centers or to patient characteristics? A Piedmont Regional Oncology Network Study
AIMS AND BACKGROUNDAlthough guidelines recommend minimalist follow-up, there is wide variability in gynecological oncology practice. The aims of this study were to describe between-center differences in the follow-up of endometrial, ovarian, and uterine cervical cancer; to identify the determinants...
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| Published in: | Tumori 2011-09, Vol.97 (5), p.551-558 |
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| creator | Fuso, Luca Evangelista, Andrea Pagano, Eva Piovano, Elisa Perotto, Stefania Mazzola, Simona Bertoldo, Emiliana La Porta, Maria Rosa Rosmino, Claudia Furbatto, Graziella Abate, Sergio Di Costanzo, Gianna Trossarelli, Gianfranco Baù, Maria Grazia Carnino, Flavio Gambaro, Giuseppina Piantanida, Paola Alabiso, Oscar Galletto, Luciano Zavallone, Laura Rossi, Annalisa Barbero, Maggiorino Tessa, Maria Katsaros, Dionyssios Danese, Saverio Brignolo, Paola Gorzegno, Gabriella Grillo, Raffaella Apolone, Giovanni Ciccone, Giovannino |
| description | AIMS AND BACKGROUNDAlthough guidelines recommend minimalist follow-up, there is wide variability in gynecological oncology practice. The aims of this study were to describe between-center differences in the follow-up of endometrial, ovarian, and uterine cervical cancer; to identify the determinants of test prescription; to estimate the related costs; and to assess the weight of center habits and patient characteristics as sources of unexplained variability. METHODS AND STUDY DESIGNThe medical records of patients treated between August 2004 and July 2005 for gynecological malignancies and followed up for the detection of recurrent disease were retrospectively collected from 29 centers of the Piedmont Oncology Network. Multivariate multilevel analyses were performed to study the determinants of test prescription and costs. RESULTSAnalyses were performed on 351 patients (median follow-up: 578 days). The unexplained variability in computed tomography prescriptions (26%), ultrasound prescriptions (17%), and total cost of follow-up (15%) can be attributed to center habits, independenty of the clinical characteristics of the patients. CONCLUSIONSMuch of the unexplained variability in the follow-up for gynecological malignancies is attributable to different habits of centers belonging to a cancer network. These results prompted us to design a multicenter randomized controlled trial to compare minimalist versus intensive follow-up programs in endometrial cancer. |
| doi_str_mv | 10.1700/989.10710 |
| format | article |
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A Piedmont Regional Oncology Network Study</title><source>Sage Journals Online</source><creator>Fuso, Luca ; Evangelista, Andrea ; Pagano, Eva ; Piovano, Elisa ; Perotto, Stefania ; Mazzola, Simona ; Bertoldo, Emiliana ; La Porta, Maria Rosa ; Rosmino, Claudia ; Furbatto, Graziella ; Abate, Sergio ; Di Costanzo, Gianna ; Trossarelli, Gianfranco ; Baù, Maria Grazia ; Carnino, Flavio ; Gambaro, Giuseppina ; Piantanida, Paola ; Alabiso, Oscar ; Galletto, Luciano ; Zavallone, Laura ; Rossi, Annalisa ; Barbero, Maggiorino ; Tessa, Maria ; Katsaros, Dionyssios ; Danese, Saverio ; Brignolo, Paola ; Gorzegno, Gabriella ; Grillo, Raffaella ; Apolone, Giovanni ; Ciccone, Giovannino</creator><creatorcontrib>Fuso, Luca ; Evangelista, Andrea ; Pagano, Eva ; Piovano, Elisa ; Perotto, Stefania ; Mazzola, Simona ; Bertoldo, Emiliana ; La Porta, Maria Rosa ; Rosmino, Claudia ; Furbatto, Graziella ; Abate, Sergio ; Di Costanzo, Gianna ; Trossarelli, Gianfranco ; Baù, Maria Grazia ; Carnino, Flavio ; Gambaro, Giuseppina ; Piantanida, Paola ; Alabiso, Oscar ; Galletto, Luciano ; Zavallone, Laura ; Rossi, Annalisa ; Barbero, Maggiorino ; Tessa, Maria ; Katsaros, Dionyssios ; Danese, Saverio ; Brignolo, Paola ; Gorzegno, Gabriella ; Grillo, Raffaella ; Apolone, Giovanni ; Ciccone, Giovannino</creatorcontrib><description>AIMS AND BACKGROUNDAlthough guidelines recommend minimalist follow-up, there is wide variability in gynecological oncology practice. The aims of this study were to describe between-center differences in the follow-up of endometrial, ovarian, and uterine cervical cancer; to identify the determinants of test prescription; to estimate the related costs; and to assess the weight of center habits and patient characteristics as sources of unexplained variability. METHODS AND STUDY DESIGNThe medical records of patients treated between August 2004 and July 2005 for gynecological malignancies and followed up for the detection of recurrent disease were retrospectively collected from 29 centers of the Piedmont Oncology Network. Multivariate multilevel analyses were performed to study the determinants of test prescription and costs. RESULTSAnalyses were performed on 351 patients (median follow-up: 578 days). The unexplained variability in computed tomography prescriptions (26%), ultrasound prescriptions (17%), and total cost of follow-up (15%) can be attributed to center habits, independenty of the clinical characteristics of the patients. CONCLUSIONSMuch of the unexplained variability in the follow-up for gynecological malignancies is attributable to different habits of centers belonging to a cancer network. These results prompted us to design a multicenter randomized controlled trial to compare minimalist versus intensive follow-up programs in endometrial cancer.</description><identifier>EISSN: 2038-2529</identifier><identifier>DOI: 10.1700/989.10710</identifier><language>eng</language><ispartof>Tumori, 2011-09, Vol.97 (5), p.551-558</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids></links><search><creatorcontrib>Fuso, Luca</creatorcontrib><creatorcontrib>Evangelista, Andrea</creatorcontrib><creatorcontrib>Pagano, Eva</creatorcontrib><creatorcontrib>Piovano, Elisa</creatorcontrib><creatorcontrib>Perotto, Stefania</creatorcontrib><creatorcontrib>Mazzola, Simona</creatorcontrib><creatorcontrib>Bertoldo, Emiliana</creatorcontrib><creatorcontrib>La Porta, Maria Rosa</creatorcontrib><creatorcontrib>Rosmino, Claudia</creatorcontrib><creatorcontrib>Furbatto, Graziella</creatorcontrib><creatorcontrib>Abate, Sergio</creatorcontrib><creatorcontrib>Di Costanzo, Gianna</creatorcontrib><creatorcontrib>Trossarelli, Gianfranco</creatorcontrib><creatorcontrib>Baù, Maria Grazia</creatorcontrib><creatorcontrib>Carnino, Flavio</creatorcontrib><creatorcontrib>Gambaro, Giuseppina</creatorcontrib><creatorcontrib>Piantanida, Paola</creatorcontrib><creatorcontrib>Alabiso, Oscar</creatorcontrib><creatorcontrib>Galletto, Luciano</creatorcontrib><creatorcontrib>Zavallone, Laura</creatorcontrib><creatorcontrib>Rossi, Annalisa</creatorcontrib><creatorcontrib>Barbero, Maggiorino</creatorcontrib><creatorcontrib>Tessa, Maria</creatorcontrib><creatorcontrib>Katsaros, Dionyssios</creatorcontrib><creatorcontrib>Danese, Saverio</creatorcontrib><creatorcontrib>Brignolo, Paola</creatorcontrib><creatorcontrib>Gorzegno, Gabriella</creatorcontrib><creatorcontrib>Grillo, Raffaella</creatorcontrib><creatorcontrib>Apolone, Giovanni</creatorcontrib><creatorcontrib>Ciccone, Giovannino</creatorcontrib><title>Variation in gynecological oncology follow-up practice: attributable to cancer centers or to patient characteristics? A Piedmont Regional Oncology Network Study</title><title>Tumori</title><description>AIMS AND BACKGROUNDAlthough guidelines recommend minimalist follow-up, there is wide variability in gynecological oncology practice. The aims of this study were to describe between-center differences in the follow-up of endometrial, ovarian, and uterine cervical cancer; to identify the determinants of test prescription; to estimate the related costs; and to assess the weight of center habits and patient characteristics as sources of unexplained variability. METHODS AND STUDY DESIGNThe medical records of patients treated between August 2004 and July 2005 for gynecological malignancies and followed up for the detection of recurrent disease were retrospectively collected from 29 centers of the Piedmont Oncology Network. Multivariate multilevel analyses were performed to study the determinants of test prescription and costs. RESULTSAnalyses were performed on 351 patients (median follow-up: 578 days). The unexplained variability in computed tomography prescriptions (26%), ultrasound prescriptions (17%), and total cost of follow-up (15%) can be attributed to center habits, independenty of the clinical characteristics of the patients. CONCLUSIONSMuch of the unexplained variability in the follow-up for gynecological malignancies is attributable to different habits of centers belonging to a cancer network. These results prompted us to design a multicenter randomized controlled trial to compare minimalist versus intensive follow-up programs in endometrial cancer.</description><issn>2038-2529</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><recordid>eNqNjb9OwzAQxi0kJApl4A1uY0qxk9DGLAghUCdABbFWrnsNBtcX7IuqvA2PiotgZ7pP35_7CXGm5ETNpLzQjZ4oOVPyQIxKWTVFeVnqI3Gc0ruUtSyn05H4ejXRGXYUwAVoh4CWPLXOGg8UfvQAG_KedkXfQReNZWfxCgxzdKuezcojMIE1wWIEi4ExJqC4N7v8ORtg38x-iNGlvE7XcANPDtdbytkC20zPuMc_3APyjuIHPHO_HsbicGN8wtPfeyLO7-9ebudFF-mzx8TLrUsWvTcBqU9LrZSu66pR1f-b3zSqZEk</recordid><startdate>20110901</startdate><enddate>20110901</enddate><creator>Fuso, Luca</creator><creator>Evangelista, Andrea</creator><creator>Pagano, Eva</creator><creator>Piovano, Elisa</creator><creator>Perotto, Stefania</creator><creator>Mazzola, Simona</creator><creator>Bertoldo, Emiliana</creator><creator>La Porta, Maria Rosa</creator><creator>Rosmino, Claudia</creator><creator>Furbatto, Graziella</creator><creator>Abate, Sergio</creator><creator>Di Costanzo, Gianna</creator><creator>Trossarelli, Gianfranco</creator><creator>Baù, Maria Grazia</creator><creator>Carnino, Flavio</creator><creator>Gambaro, Giuseppina</creator><creator>Piantanida, Paola</creator><creator>Alabiso, Oscar</creator><creator>Galletto, Luciano</creator><creator>Zavallone, Laura</creator><creator>Rossi, Annalisa</creator><creator>Barbero, Maggiorino</creator><creator>Tessa, Maria</creator><creator>Katsaros, Dionyssios</creator><creator>Danese, Saverio</creator><creator>Brignolo, Paola</creator><creator>Gorzegno, Gabriella</creator><creator>Grillo, Raffaella</creator><creator>Apolone, Giovanni</creator><creator>Ciccone, Giovannino</creator><scope>7X8</scope></search><sort><creationdate>20110901</creationdate><title>Variation in gynecological oncology follow-up practice: attributable to cancer centers or to patient characteristics? A Piedmont Regional Oncology Network Study</title><author>Fuso, Luca ; Evangelista, Andrea ; Pagano, Eva ; Piovano, Elisa ; Perotto, Stefania ; Mazzola, Simona ; Bertoldo, Emiliana ; La Porta, Maria Rosa ; Rosmino, Claudia ; Furbatto, Graziella ; Abate, Sergio ; Di Costanzo, Gianna ; Trossarelli, Gianfranco ; Baù, Maria Grazia ; Carnino, Flavio ; Gambaro, Giuseppina ; Piantanida, Paola ; Alabiso, Oscar ; Galletto, Luciano ; Zavallone, Laura ; Rossi, Annalisa ; Barbero, Maggiorino ; Tessa, Maria ; Katsaros, Dionyssios ; Danese, Saverio ; Brignolo, Paola ; Gorzegno, Gabriella ; Grillo, Raffaella ; Apolone, Giovanni ; Ciccone, Giovannino</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-proquest_miscellaneous_9119443813</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fuso, Luca</creatorcontrib><creatorcontrib>Evangelista, Andrea</creatorcontrib><creatorcontrib>Pagano, Eva</creatorcontrib><creatorcontrib>Piovano, Elisa</creatorcontrib><creatorcontrib>Perotto, Stefania</creatorcontrib><creatorcontrib>Mazzola, Simona</creatorcontrib><creatorcontrib>Bertoldo, Emiliana</creatorcontrib><creatorcontrib>La Porta, Maria Rosa</creatorcontrib><creatorcontrib>Rosmino, Claudia</creatorcontrib><creatorcontrib>Furbatto, Graziella</creatorcontrib><creatorcontrib>Abate, Sergio</creatorcontrib><creatorcontrib>Di Costanzo, Gianna</creatorcontrib><creatorcontrib>Trossarelli, Gianfranco</creatorcontrib><creatorcontrib>Baù, Maria Grazia</creatorcontrib><creatorcontrib>Carnino, Flavio</creatorcontrib><creatorcontrib>Gambaro, Giuseppina</creatorcontrib><creatorcontrib>Piantanida, Paola</creatorcontrib><creatorcontrib>Alabiso, Oscar</creatorcontrib><creatorcontrib>Galletto, Luciano</creatorcontrib><creatorcontrib>Zavallone, Laura</creatorcontrib><creatorcontrib>Rossi, Annalisa</creatorcontrib><creatorcontrib>Barbero, Maggiorino</creatorcontrib><creatorcontrib>Tessa, Maria</creatorcontrib><creatorcontrib>Katsaros, Dionyssios</creatorcontrib><creatorcontrib>Danese, Saverio</creatorcontrib><creatorcontrib>Brignolo, Paola</creatorcontrib><creatorcontrib>Gorzegno, Gabriella</creatorcontrib><creatorcontrib>Grillo, Raffaella</creatorcontrib><creatorcontrib>Apolone, Giovanni</creatorcontrib><creatorcontrib>Ciccone, Giovannino</creatorcontrib><collection>MEDLINE - Academic</collection><jtitle>Tumori</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fuso, Luca</au><au>Evangelista, Andrea</au><au>Pagano, Eva</au><au>Piovano, Elisa</au><au>Perotto, Stefania</au><au>Mazzola, Simona</au><au>Bertoldo, Emiliana</au><au>La Porta, Maria Rosa</au><au>Rosmino, Claudia</au><au>Furbatto, Graziella</au><au>Abate, Sergio</au><au>Di Costanzo, Gianna</au><au>Trossarelli, Gianfranco</au><au>Baù, Maria Grazia</au><au>Carnino, Flavio</au><au>Gambaro, Giuseppina</au><au>Piantanida, Paola</au><au>Alabiso, Oscar</au><au>Galletto, Luciano</au><au>Zavallone, Laura</au><au>Rossi, Annalisa</au><au>Barbero, Maggiorino</au><au>Tessa, Maria</au><au>Katsaros, Dionyssios</au><au>Danese, Saverio</au><au>Brignolo, Paola</au><au>Gorzegno, Gabriella</au><au>Grillo, Raffaella</au><au>Apolone, Giovanni</au><au>Ciccone, Giovannino</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Variation in gynecological oncology follow-up practice: attributable to cancer centers or to patient characteristics? A Piedmont Regional Oncology Network Study</atitle><jtitle>Tumori</jtitle><date>2011-09-01</date><risdate>2011</risdate><volume>97</volume><issue>5</issue><spage>551</spage><epage>558</epage><pages>551-558</pages><eissn>2038-2529</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>content type line 23</notes><notes>ObjectType-Feature-2</notes><abstract>AIMS AND BACKGROUNDAlthough guidelines recommend minimalist follow-up, there is wide variability in gynecological oncology practice. The aims of this study were to describe between-center differences in the follow-up of endometrial, ovarian, and uterine cervical cancer; to identify the determinants of test prescription; to estimate the related costs; and to assess the weight of center habits and patient characteristics as sources of unexplained variability. METHODS AND STUDY DESIGNThe medical records of patients treated between August 2004 and July 2005 for gynecological malignancies and followed up for the detection of recurrent disease were retrospectively collected from 29 centers of the Piedmont Oncology Network. Multivariate multilevel analyses were performed to study the determinants of test prescription and costs. RESULTSAnalyses were performed on 351 patients (median follow-up: 578 days). The unexplained variability in computed tomography prescriptions (26%), ultrasound prescriptions (17%), and total cost of follow-up (15%) can be attributed to center habits, independenty of the clinical characteristics of the patients. CONCLUSIONSMuch of the unexplained variability in the follow-up for gynecological malignancies is attributable to different habits of centers belonging to a cancer network. These results prompted us to design a multicenter randomized controlled trial to compare minimalist versus intensive follow-up programs in endometrial cancer.</abstract><doi>10.1700/989.10710</doi></addata></record> |
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| ispartof | Tumori, 2011-09, Vol.97 (5), p.551-558 |
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| language | eng |
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| source | Sage Journals Online |
| title | Variation in gynecological oncology follow-up practice: attributable to cancer centers or to patient characteristics? A Piedmont Regional Oncology Network Study |
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