M. Janelle Cambron-Mellott

Oncologist perceptions of “cure” and long-term management in advanced ovarian cancer in the United States: results from a cross-sectional survey

Treatment advancements have improved survival outcomes for patients with advanced ovarian cancer. In advanced ovarian cancer, some physicians believe discussing "cure" as a potential treatment goal may be premature. In contrast, others note that the durable responses observed among some patients may suggest that long-term remission or "cure" are legitimate outcomes to strive for. Despite this, the term 'cure' has no accepted definition in this setting, and whether physicians are willing to use this language is unknown. A cross-sectional, internet-based survey was conducted to evaluate United States oncologists' attitudes and beliefs related to "cure" in the context of treating patients with newly diagnosed advanced ovarian cancer. The survey included questions on attitudes and beliefs toward patient prognosis with newly diagnosed advanced ovarian cancer, oncologists' perceptions of clinical outcomes, oncologist characteristics, and clinical practice details. Among 150 oncologists, when addressing the topic of disease prognosis or treatment goals in patients newly diagnosed with stage III-IV ovarian cancer, the terms endorsed by more than half of oncologists were "achieve long-term remission" and "achieve long-term response." Terms including "cure" or "curable" were endorsed by less than 35% of oncologists. Among several patient characteristics evaluated, no evidence of disease for 5 to 10 years was most indicative of cure. In the context of primary disease, the proportion of oncologists who would tell a patient with advanced ovarian cancer they were cured, even if they believe it to be true, decreased with the stage (II = 73.8%; III = 60.8%; IV = 50.5%). The current study found that while oncologists may believe a cure is possible across early stages of ovarian cancer, many remain hesitant to discuss the potential of "cure" with patients, particularly those with stage IV disease.