Mode of Referral of Ovarian Cancer Patients: Does it Alter Treatment and Survival?

Abstract

Background/Aim: Some studies have shown that ovarian cancer patients admitted after referral to the emergency department had a worse prognosis than those referred through non-emergency pathways. We believe that our study is the first in the UK to explore this difference and aimed to compare the 1-year, 3-year, and 5-year overall survival rates of ovarian cancer patients referred non-urgently from the general practitioner (GP) vs. patients referred urgently to the emergency department (ED). Patients and Methods: This was a retrospective cohort study conducted at the University Hospitals of Leicester (UHL) from 1st January 2015 to 31st December 2019 involving 298 ovarian cancer patients: 197 referred non-urgently from the GP and 101 patients referred to the ED. Results: There was no significant difference in the 1-year, 3-year, and 5-year overall survival in ovarian cancer patients referred from the GP compared to patients referred to the ED, 84.8%, 62.2%, and 48.4% versus 80.2%, 64.8%, and 43.5%, respectively (p=0.732). Conclusion: The mode of referral for ovarian cancer patients may not affect their prognosis. Prompt referral to the gynaecological oncology multidisciplinary team, a good acute oncology service, early imaging and image-guided diagnostic pathways, timely appointment, and timely initiation of treatment in our centre may have minimized the difference in outcome in the two groups.