Factors associated with the suboptimal treatment of women less than 55 years of age with early-stage ovarian cancer

John K. Chan, Daniel S. Kapp, Jacob Y. Shin, Kathryn Osann, Gary S Leiserowitz, Rosemary D Cress, Cynthia O'Malley

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Objectives: A significant number of young patients with early-stage ovarian cancer did not receive chemotherapy based on standard practice guidelines. We investigated factors associated with the suboptimal treatment in these women. Materials and Methods: Data were obtained from California Cancer Registry from 1994 to 1996. Kaplan-Meier and Cox proportional hazard methods were used. Results: Of 135 younger (< 55 years) patients with stages IC-II epithelial ovarian cancers, 29 (21.5%) did not receive chemotherapy (group A) while the remaining 106 (78.5%) had adjuvant chemotherapy (group B). Women in group A were more likely to live in poor neighborhoods (58.6% vs. 38.7%; p = 0.055), less likely to be seen by a gynecologic oncologist (13.8% vs. 39.6%; p = 0.009), and had more grade 1 and 2 tumors (58.6% vs. 37.8%; p = 0.049). The 5-year disease-specific survival of group A was 70.5% compared to 76.5% in group B (p = 0.252). Of note, patients residing in poor neighborhoods had a statistically significant improvement in survival (from 65.5% to 86.0%; p = 0.012) associated with chemotherapy, but this difference was not noted for women in non-poor neighborhoods (77.1% vs. 70.9%; p = 0.574). On multivariate analysis, those treated by gynecologic oncologists were more likely to receive chemotherapy (95% CI:1.33-12.63; p = 0.006). Discussion: A significant number of young women with stages IC-II epithelial ovarian cancer did not receive chemotherapy. The factors associated with this suboptimal treatment of young women with stages IC-II ovarian cancer include living in poor neighborhoods and lack of care by a gynecologic oncologist.

Original languageEnglish (US)
Pages (from-to)95-99
Number of pages5
JournalGynecologic Oncology
Volume108
Issue number1
DOIs
StatePublished - Jan 2008

Keywords

  • Chemotherapy
  • Ovarian cancer
  • Younger women

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

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