Compliance of Pan-Birmingham Gynaecological Cancer Centre with National

and International Ovarian Cancer Quality Performance Indicators (QPIs) in 2023

Students: Harshitha Naidu (ID:2125907), Tharuka Nanomi Arachchige (ID:2130487)
Supervisors: Mr Janos Balega, Miss Teju Olaoye

Aim: Introduction:
Introduction: Methods:
Methods:
To assess the Pan-Birmingham Gynaecological Cancer Centre's Ovarian cancer presents a significant healthcare challenge in the United Retrospective review of ovarian cancer cytoreductive
(PBGCC) fulfilment of quality performance indicators (QPIs) Kingdom, characterized by higher mortality rates and a notable treatment surgeries undertaken at PBGCC in 2023. Clinical
outlined by the British Gynaecological Cancer Society (BGCS) deficit compared to countries with similar socio-economic profiles [1]. The data was obtained from computerised notes and
and European Society of Gynaecological Oncology (ESGO) in National Ovarian Cancer Audit feasibility pilot showed that 25% of women analysed using a specialized QPI tool comprising of
the management of ovarian cancer. This audit also aimed to with FIGO Stage II-IV ovarian cancer receive no treatment and only 51% nine parameters as below:
[1,5]

identify any shortcomings and analyse the reasons for of patients receive the optimal care . This large variability highlights the
[2,3] • Germline genomics
deviations. need for an examination of curative practices, specifically of the • Tumour genomics
Graph 2 - European Society of Gynaecological Oncology recommended first-line management: cytoreductive surgery [4]. • Operation type
Graph 1 - British Gynaecological Cancer Society • Residual disease
9 Conclusion:
100% Conclusion: • Pathology
8
90% The PBGCC currently attains most • FIGO stage
7 of the QPIs recognised as significant
80% • Surgeons
6 70% identifiers of optimal care provision • Involvement in clinical trials
5 60%
in ovarian cancer treatment. Based
50%
• Cancer origin
4 on these QPIs, the PBGCC qualifies
40%
3 for ESGO Standard
30%
2 20% Accreditation[5].However, rates of
1 Results:
Results:
10% genomic testing fall below the target
0 0%
1 4a 4b 5a 5b recommended by BGCS. The centre scored of 34 out of 40 points from the
1.1 1.2 2.1 2.2 3 4 5 6 7 8 9 10
ESGO QPI scoring system and met 5 out of the 8
Highest scoring Outcome (points) Target Outcome
QPI targets from the BSGS guidelines (Graph 1 and
Recommendations: 2).The rate of genomic testing was below the target
- More robust data imputation into the electronic patient data systems, specifically in terms of the operation notes and MDTs. level, at 66% and 69%, respectively for QPIs 5a and
- Increased genomic testing and vigilant follow up of genomic test results. 5b. Patients were not enrolled in NCRI portfolio
- The appointment of a genomic specialist nurse should also improve genomic testing rates and facilitate the achievement of the QPIs. studies, which did not allow for this QPI to be met.
References
1. Sundar S et al. British Gynaecological Cancer Society Recommendations for Evidence Based, Population Data Derived Quality Performance Indicators for Ovarian Cancer. Cancers [Internet]. 2023 Jan 4 [cited 2023 Apr 17];15(2):337. Available from:
http://pure-oai.bham.ac.uk/ws/portalfiles/portal/185845689/cancers_15_00337_v2.pdf
2. OCAFPS. Ovarian Cancer Audit Feasibility Pilot - Disease Profile in England: Incidence, Mortality, Stage and Survival for Ovary, Fallopian Tube and Primary Peritoneal Carcinomas; Public Health England [Internet]. 2020 Jan. Available from: https://digital.nhs.uk/ndrs/data/data-
outputs/ovarian-cancer-audit-feasibility-pilot-ocafp---project-summary-report/disease-profile-in-england
3. Prat J, FIGO Committee on Gynecologic Oncology. Staging Classification for Cancer of the ovary, Fallopian tube, and Peritoneum. International Journal of Gynecology & Obstetrics. 2013 Oct 22;124(1):1–5.
4. Fotopoulou C et al. British Gynaecological Cancer Society (BGCS) Epithelial ovarian/fallopian tube/primary Peritoneal Cancer guidelines: Recommendations for Practice. European Journal of Obstetrics & Gynecology and Reproductive Biology [Internet]. 2017 Jun;213:123–39.
Available from: https://www.bgcs.org.uk/wp-content/uploads/2019/05/BGCS-Guidelines-Ovarian-Guidelines-2017.pdf
5. Fotopoulou, C., Planchamp, F. and Concin, N. (2020) Quality Indicators for Advanced Ovarian Cancer Surgery from the European Society of Gynaecological Oncology (ESGO): 2020 update, International journal of gynecological cancer : official journal of the International
Gynecological Cancer Society. Available at: https://pubmed.ncbi.nlm.nih.gov/32086362/ (Accessed: 09 November 2023).