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

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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

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Ovarian Neoplasms
Drug Therapy
Therapeutics
Survival
Adjuvant Chemotherapy
Practice Guidelines
Registries
Neoplasms
Multivariate Analysis
Oncologists
Ovarian epithelial cancer

Keywords

  • Chemotherapy
  • Ovarian cancer
  • Younger women

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Factors associated with the suboptimal treatment of women less than 55 years of age with early-stage ovarian cancer. / Chan, John K.; Kapp, Daniel S.; Shin, Jacob Y.; Osann, Kathryn; Leiserowitz, Gary S; Cress, Rosemary D; O'Malley, Cynthia.

In: Gynecologic Oncology, Vol. 108, No. 1, 01.2008, p. 95-99.

Research output: Contribution to journalArticle

Chan, John K. ; Kapp, Daniel S. ; Shin, Jacob Y. ; Osann, Kathryn ; Leiserowitz, Gary S ; Cress, Rosemary D ; O'Malley, Cynthia. / Factors associated with the suboptimal treatment of women less than 55 years of age with early-stage ovarian cancer. In: Gynecologic Oncology. 2008 ; Vol. 108, No. 1. pp. 95-99.
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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.",
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T1 - Factors associated with the suboptimal treatment of women less than 55 years of age with early-stage ovarian cancer

AU - Chan, John K.

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AU - Shin, Jacob Y.

AU - Osann, Kathryn

AU - Leiserowitz, Gary S

AU - Cress, Rosemary D

AU - O'Malley, Cynthia

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N2 - 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.

AB - 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.

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