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    • Patterns of Care and Development of Quality Indicators in Patients with Non-Epithelial and Rare Ovarian Tumours in Australia: Insights from the National Gynae-Oncology Registry.

    Yeh Chen Lee, Aleesha Whitely,Michael Burling,Lyndal Anderson,Paul A. Cohen,Mahendra Naidoo,Gary Richardson,Sharnel Perera,Clare L. Scott,Michael Friedlander,Alison Brand,Orla McNally,Simon Hyde,Michael Bunting,Tom Jobling,John Zalcberg, Robert Rome

    International Journal of Gynecological Cancer（2024）SCI 3区SCI 4区

    School of Clinical Medicine | School of Public Health and Preventive Medicine | University of Sydney | Royal Prince Alfred Hospital | University of Western Australia | Cabrini Health | The Walter and Eliza Hall Institute of Medical Research | University of Melbourne | Royal Hobart Hospital | Monash Health | Epworth HealthCare

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    Abstract
    Objectives The Rare Ovarian Tumour Module forms part of the National Gynae-Oncology Registry (NGOR) which measures compliance with the optimal care pathways for gynaecological cancer in Australia. Our objectives were to evaluate patterns of care in patients with non-epithelial ovarian tumours and to develop appropriate clinical quality indicators. Methods A multidisciplinary reference group developed a module dataset in the NGOR REDCap database to collect clinical data using an opt-out recruitment model across participating Australian hospitals. Clinical quality indicators were developed and refined using consensus methods, with annual reports provided to participating sites to benchmark performance and drive improvement in patient care. Results As of November 2023, 232 patients from 18 Australian hospitals were enrolled. All cases had histological confirmation with the majority being adult granulosa cell tumour (47.8%). Almost all patients (97.8%) were presented at a multidisciplinary team meeting. Most had early-stage disease (stage, I 70.3%; II 9.9%; III 9.1%; IV 3.4%; not documented 7.3%) and had surgery alone (72.4%). Thirty-four patients underwent multiple surgeries as primary treatment (14.7%), with a median time to a second surgical procedure of 47 days (IQR=36-71). Two-thirds of patients (65.4%) had their first surgery performed by a gynaecologic oncologist. Rates of intraoperative and 30-day postoperative adverse events (Clavien-Dindo ≥Grade III) were low, 4.3% and 1.9% respectively. Of 52 patients with stage II disease and higher, 37 (71.2%) received systemic therapy. A high rate of adherence to the four clinical quality indicators as measures of best practice care was observed. Conclusion The NGOR Rare Ovarian Tumour Module has successfully collated relevant data to study patterns of care to inform the development of clinical quality indicators and enable research for these rare tumours. This national collaboration has the potential for benchmarking outcomes in Australia with international experience.
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    【要点】：本文通过澳大利亚国家妇科肿瘤注册中心的数据，研究了非上皮性卵巢肿瘤患者的治疗模式，并开发了相应的临床质量指标。
    

    【方法】：通过多学科参考小组在NGOR REDCap数据库中开发模块数据集，采用选择退出招募模式，在参与的澳大利亚医院中收集临床数据，并使用共识方法开发和完善临床质量指标。
    

    【实验】：截至2023年11月，共有来自18家澳大利亚医院的232名患者参与。所有病例均经组织学确认，大多数为成年颗粒细胞瘤（47.8%）。几乎所有患者（97.8%）都在多学科团队会议上进行了介绍。大多数患者处于早期疾病阶段（I期70.3%；II期9.9%；III期9.1%；IV期3.4%；未记录7.3%），并且仅接受了手术（72.4%）。34名患者接受了多次手术作为主要治疗（14.7%），第二次手术的中位时间为47天（IQR=36-71）。三分之二的患者（65.4%）的首次手术由妇科肿瘤学家完成。术中及术后30天内不良事件（Clavien-Dindo ≥III级）发生率低，分别为4.3%和1.9%。在52名II期及以上疾病的患者中，有37人（71.2%）接受了系统治疗。观察到对四项临床质量指标的遵守率高，这些指标被认为是最佳实践护理的衡量标准。