John K Chan1, Mallory Zhang, Jessica M Hu, Jacob Y Shin, Kathryn Osann, Daniel S Kapp. 1. Division of Gynecologic Oncology, Department of Obsetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco School of Medicine, UCSF Comprehensive Cancer Center, San Francisco, CA 94143-1702, USA. chanjohn@obgyn.ucsf.edu
Abstract
OBJECTIVE: To compare the racial differences in treatment and survival of epithelial ovarian cancer patients. METHODS: Data were obtained from the Surveillance, Epidemiology, and End Results Program between 1988 and 2001 and analyzed using Kaplan-Meier methods and Cox proportional hazards regression. RESULTS: Of the 24,038 women, 22,407 (93.2%) were non-Hispanic White, and 1,631 (6.8%) were African-American. Median age of Whites versus African-Americans was 65 versus 63 years, respectively (P < 0.001). Of the patients with early-stage (I-II) disease, 38.8% of Whites underwent lymphadenectomy with their primary surgery compared to only 32.8% of African-Americans (P = 0.005). In the overall study group, the 5-year disease-specific survival of Whites was significantly higher compared to the African-Americans (44.1% vs. 40.7%, P = 0.001). On multivariable analysis, age, race, stage, cell type, and grade of disease were all independent prognostic factors for survival. CONCLUSION: Our data suggest that race is an independent prognostic factor for survival in epithelial ovarian cancer. In addition, African-Americans with early-stage cancer were less likely to undergo lymphadenectomy with their staging procedure. Furthermore, patient/physician education is needed to increase the number of patients undergoing surgical staging procedures for epithelial ovarian cancer.
OBJECTIVE: To compare the racial differences in treatment and survival of epithelial ovarian cancerpatients. METHODS: Data were obtained from the Surveillance, Epidemiology, and End Results Program between 1988 and 2001 and analyzed using Kaplan-Meier methods and Cox proportional hazards regression. RESULTS: Of the 24,038 women, 22,407 (93.2%) were non-Hispanic White, and 1,631 (6.8%) were African-American. Median age of Whites versus African-Americans was 65 versus 63 years, respectively (P < 0.001). Of the patients with early-stage (I-II) disease, 38.8% of Whites underwent lymphadenectomy with their primary surgery compared to only 32.8% of African-Americans (P = 0.005). In the overall study group, the 5-year disease-specific survival of Whites was significantly higher compared to the African-Americans (44.1% vs. 40.7%, P = 0.001). On multivariable analysis, age, race, stage, cell type, and grade of disease were all independent prognostic factors for survival. CONCLUSION: Our data suggest that race is an independent prognostic factor for survival in epithelial ovarian cancer. In addition, African-Americans with early-stage cancer were less likely to undergo lymphadenectomy with their staging procedure. Furthermore, patient/physician education is needed to increase the number of patients undergoing surgical staging procedures for epithelial ovarian cancer.
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