The Cancer Registry accessioned a total of 1889 cancer cases at New Hanover Regional Medical Center in 2005. A total of 1727 were analytical cases, those that were diagnosed and/or received all or part of their first course of treatment here. Non-analytical cases totaled 162. The cancer registry database currently contains approximately 23,585 cases. The lifetime follow-up rate for these patients has remained at or above 90%, a requirement of the Commission on Cancer.

The data collected in the Cancer Registry is routinely submitted to the North Carolina State Cancer Registry and the National Cancer Data Base. Cancer Registry data is used internally and externally for benchmarking, identifying trends, supporting new programs, studies and strategic planning.

Approximately 61 Tumor Board and GYN Oncology Conferences were supported by the Cancer Registry staff. Responsibilities include identifying cases for presentation, collecting all related internal and external correspondence and test results, room set up and audio-visual support. These efforts contribute to a smooth-functioning, multi-disciplinary conference in which the management and treatment of our patients is discussed for optimal outcomes.

The members of the Cancer Registry staff include Beverly Gould, RHIT, JoAnn Koch, Leigh Hardy, CTR, and Christine Smith, RHIT. Staff members appreciated the opportunity to attend several educational sessions and meetings at the State and National level which has enhanced their professional growth. The staff played a key role in the implementation of the PACS system at Tumor Board, which has led to greater efficiency, increased physician satisfaction and ultimately contributes to the quality review of cancer cases. Cancer Registry Week was celebrated with an Open House, hosted by the registry staff, which provided a forum for educating our colleagues on the functions of the registry. Communication regarding the profession was relayed via bulletin boards and the intranet. The staff also participated in several community outreach activities such as the Prostate Cancer Screening, Cancer Survivors Day, GYN Cancer Awareness Month Reception, Hospitality House Room Renovation Project and Relay for Life.

The Registry Staff would like to thank Beth Mathews, RN, BSN, MBA, OCN, Director of Cancer Services, Peter Ungaro, M.D., Oncology Advisory Committee Chair, and Cyrus Kotwall, M.D. Cancer Center Liaison, for their support and advocacy for the Cancer Registry Staff and Services.

Respectfully submitted,

Nora Landry, BS, CTR

NHRMC 2005 Ovarian Cancer Site Analysis

Ovarian Cancer is the number one cause of death in women with reproductive malignancies each year. There are approximately 22,000 women diagnosed with Ovarian Cancer each year with a death rate of approximately 14,500 women. Ovarian cancer is a very compelling disease because the diagnosis is usually made in its advanced stages and there is presently no effective means of screening these women in hopes of detecting the disease in an earlier and more curable stage. Ongoing clinical trials, in which the Zimmer Cancer Center participates, continue to evaluate new chemotherapeutic regimens in the treatment of Ovarian Cancer as well as screening women with pelvic masses in hopes of developing a panel of tumor markers that will predict a likelihood of Ovarian Cancer prior to surgery.

This year we analyzed the Ovarian Cancer cases seen within New Hanover Regional Medical Center in 2005. Our goal was to compare the demographics of patients diagnosed with Ovarian Cancer in that year and then to compare the survival data for a similar cohort of patients diagnosed in the years 1992-1998 to the available SEER data available through the NCI.

A systematic review of all of the tumor registry cases of Ovarian Cancers diagnosed and treated at New Hanover Regional Medical Center for 2005 as well as for 2001-2005 were undertaken. A total of 37 Ovarian Cancers were diagnosed at New Hanover Regional Medical Center in 2005. The distribution by race was 30 (81%) in white women and 7 (19%) in African American women. The distribution by stage at diagnosis was consistent with that found in the general population; however, there did seem to be a higher percentage of the stage four disease. There were 8 (22%) stage one, 11 (30%) stage three, 16 (43%) stage four disease and 2 (5%) unknown stage. The two patients with unknown stage were most likely stage three; however, for various reasons these patients were not officially staged.

With regards to the treatment for these patients diagnosed in 2005, 21 (56%) underwent surgery followed by chemotherapy, 8 (22%) received chemotherapy alone, 4 (11%) received surgery alone and 4 (11%) received no treatment at all. Three of the four patients that did not receive any treatment had either significant co-morbid disease or were too sick to receive any treatment. The fourth patient refused treatment and died three months after diagnosis.

When comparing these distribution of Ovarian Cancer by stage and analyzing survival data, we evaluated a five year subset first from 1995-2001 where the distribution by stage was consistent with the published SEER data available for comparison. Similarly the age of patients at diagnosis correlated well with known SEER data. When analyzing survival rates the latest SEER data available was 1992-1998 and comparison of survival data from the SEER data base with the survival at New Hanover Regional Medical Center for a similar cohort of patients revealed a close correlation for survival rates based on stage of diagnosis.

Therefore, we feel the incidence of Ovarian Cancer in this area of North Carolina is consistent with national averages. The treatment afforded these patients is also consistent with standard treatment guidelines used at this time.

I would like to thank Nora Landry and the Tumor Registry Staff at New Hanover Regional Medical Center for their assistance in preparing this review.

Respectfully,

Walter Gajewski, MD

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