A review of gynaecological cancer management: a large West Midlands general hospital experience

Abstract

The records of 372 women with gynaecological cancer were reviewed to assess the quality of care which has been given and to compare the standards achieved with those suggested by The West Midlands Gynaecological Oncology Group. The median primary referral interval was 18 days; 54% of patients were seen within 2 weeks of referral. The median interval between first hospital visit and surgery was 32 days and 77·5% of patients had their operation within 8 weeks. The median interval between histology report and starting adjuvant therapy was 19 days and 81% of patients commenced treatment within 6 weeks. The histological diagnosis was available within 2 weeks of surgery in 77% of patients. Less than one-third of patients in our series were referred to the lead consultant of gynaecological oncology, who performed 50% of the operations for gynaecological malignancy. There was no record of the primary referral interval, date of surgery and date of commencement of adjuvant therapy in 35%, 25% and 20% of patients, respectively. More attention must be given to redistribution of caseload with more involvement of the gynaecological cancer team and to improvement in clinical cancer data collection to decrease the extent of missing data. The delays in referral of patients with suspected gynaecological malignancy could be minimised by improving communication between the general practitioners and the hospitals.