Analysis of the relationship between hospital characteristics and survival in ovarian cancer: A historical cohort

Background and Objectives The management of ovarian cancer requires complex surgical and medical interventions. Specialized care is associated with superior outcomes in early and advanced stages. This study aimed to estimate the effect of hospital characteristics on the overall survival of women with epithelial ovarian cancer. Methods We established a cohort with data recorded by the Fundação Oncocentro de São Paulo cancer registry. We included 6111 women treated for ovarian cancer in the state of Sao Paulo from January 2000 to December 2018. From 76 hospitals analyzed, 7 were high volume (20 or more cases a year) and 69 low volume. Twenty‐nine were teaching and 47 community hospitals. A 10‐year survival was analyzed using the Kaplan‐Meyer estimator and the Cox model. Results Fifty‐two percent of the epithelial ovarian cancer patients were treated in high‐volume hospitals. High‐volume ‐ (HR, 0.86; 95% CI, 0.8‐0.92; P  < .001) and teaching ‐ (HR, 0.91; 95% CI, 0.85‐0.99; P  = .019) were hospital characteristics associated with low risk of death in 10 years. Conclusions High‐volume and teaching hospitals are associated with better overall survival in ovarian cancer. Our data suggest that both hospital characteristics are important indicators of good quality of care in ovarian cancer treatment.