Treatment of advanced ovarian cancer in Germany: The impact of participation in clinical trials

The purpose of this study was to evaluate the impact of participation in clinical trial on the pattern of care of patients with advanced ovarian cancer in Germany. We performed a survey including a representative collective of 87 institutions. The records of 501 patients treated for ovarian cancer between July and September 2000 were evaluated. The 411 patients with FIGO stages IIB - IV ovarian cancer were selected. The study population represented about one third of all patients with advanced ovarian cancer treated in Germany in this period. The impact of participation in prospective clinical trials on pattern and results of surgical and chemotherapeutic treatments were analyzed. Only about two thirds of patients with advanced ovarian cancer received a chemotherapy according to actual standard recommendations. There was a considerable heterogenity with respect to type of institution (participating in clinical trial or not). The same accounted for surgical care. Patients treated in hospitals participating in clinical trials had a significant higher chance of surgery resulting in tumor residuals less than 2 cm diameter, and to receive a chemotherapy regimen according to standard recommendations: 92% vs. 58% in hospitals not participating in clinical trials. The latter treated about three quarters of all patients in the observation period.