David A Barrington1, Sarah E Dilley2, Emily E Landers1, Eric D Thomas2, Jonathon D Boone2, J Michael Straughn2, Gerald McGwin3, Charles A Leath4. 1. University of Alabama, Birmingham Department of Obstetrics & Gynecology, United States. 2. University of Alabama, Birmingham Division of Gynecologic Oncology, United States. 3. University of Alabama, Birmingham Department of Epidemiology, United States. 4. University of Alabama, Birmingham Division of Gynecologic Oncology, United States. Electronic address: cleath@uabmc.edu.
Abstract
OBJECTIVE: To evaluate the potential relationship between outcomes in cervical cancer patients based on distance from our Comprehensive Cancer Center (CCC). METHODS: A retrospective cohort study of cervical cancer patients was performed. Abstracted data included: demographics, clinicopathologic variables, treatment, and survival. Analyses both by quartiles and distance <100 and ≥100miles from our institution were performed. Data were analyzed using SAS version 9.2. RESULTS: 390 patients living a median distance of 58.1miles (range 1.2-571miles) from our CCC were identified. Patients were generally white (n=249), non-smokers (n=226), with Stage IB disease (n=222), squamous histology (n=295) and underwent primary surgical therapy (n=229). Patients were divided into both quartiles as well as two strata: <100 and ≥100miles for comparison. Progression-free survival (PFS) and overall survival (OS) favored patients living closer to our center with a lower median OS for patients living ≥100miles (65.4vs. 99.4months; p=0.040). Cox proportional hazard modeling noted that advanced stage was predictive of inferior PFS and OS, while other clinical covariates including age, BMI, race, smoking status and histology had a variable impact on outcomes and distance >100miles was associated with a higher risk of death (hazard ratio [HR]=1.68, 95% confidence interval [CI] 1.11-2.54). CONCLUSION: Overall survival for patients living >100miles from our CCC was worse when compared to patients in closer proximity. Outreach efforts and utilization of navigators may help decrease the impact of geographic and racial disparities on outcomes.
OBJECTIVE: To evaluate the potential relationship between outcomes in cervical cancerpatients based on distance from our Comprehensive Cancer Center (CCC). METHODS: A retrospective cohort study of cervical cancerpatients was performed. Abstracted data included: demographics, clinicopathologic variables, treatment, and survival. Analyses both by quartiles and distance <100 and ≥100miles from our institution were performed. Data were analyzed using SAS version 9.2. RESULTS: 390 patients living a median distance of 58.1miles (range 1.2-571miles) from our CCC were identified. Patients were generally white (n=249), non-smokers (n=226), with Stage IB disease (n=222), squamous histology (n=295) and underwent primary surgical therapy (n=229). Patients were divided into both quartiles as well as two strata: <100 and ≥100miles for comparison. Progression-free survival (PFS) and overall survival (OS) favored patients living closer to our center with a lower median OS for patients living ≥100miles (65.4vs. 99.4months; p=0.040). Cox proportional hazard modeling noted that advanced stage was predictive of inferior PFS and OS, while other clinical covariates including age, BMI, race, smoking status and histology had a variable impact on outcomes and distance >100miles was associated with a higher risk of death (hazard ratio [HR]=1.68, 95% confidence interval [CI] 1.11-2.54). CONCLUSION: Overall survival for patients living >100miles from our CCC was worse when compared to patients in closer proximity. Outreach efforts and utilization of navigators may help decrease the impact of geographic and racial disparities on outcomes.
Authors: Daniel Polsky; Katrina A Armstrong; Thomas C Randall; Richard N Ross; Orit Even-Shoshan; Paul R Rosenbaum; Jeffrey H Silber Journal: Health Serv Res Date: 2006-12 Impact factor: 3.402
Authors: Charles A Leath; J Michael Straughn; Tyler O Kirby; Adam Huggins; Edward E Partridge; Groesbeck P Parham Journal: Gynecol Oncol Date: 2005-08-30 Impact factor: 5.482
Authors: Linda C Harlan; Amanda L Greene; Limin X Clegg; Margaret Mooney; Jennifer L Stevens; Martin L Brown Journal: J Clin Oncol Date: 2005-11-21 Impact factor: 44.544
Authors: Lois M Ramondetta; Larissa A Meyer; Kathleen M Schmeler; Maria E Daheri; Jessica Gallegos; Michael Scheurer; Jane R Montealegre; Andrea Milbourne; Matthew L Anderson; Charlotte C Sun Journal: Gynecol Oncol Date: 2015-10-21 Impact factor: 5.482
Authors: Daniel G Petereit; Kevin Molloy; Mary L Reiner; Petra Helbig; Kristin Cina; Raylene Miner; Caroline Spotted Tail; Catherine Rost; Patricia Conroy; Chester R Roberts Journal: Cancer Control Date: 2008-07 Impact factor: 3.302
Authors: David A Barrington; Jennifer A Sinnott; Corinne Calo; David E Cohn; Casey M Cosgrove; Ashley S Felix Journal: Gynecol Oncol Date: 2020-06-09 Impact factor: 5.482
Authors: Eliza W Beal; Rittal Mehta; Katiuscha Merath; Diamantis I Tsilimigras; J Madison Hyer; Anghela Paredes; Mary E Dillhoff; Jordan Cloyd; Aslam Ejaz; Timothy M Pawlik Journal: J Gastrointest Surg Date: 2019-05-08 Impact factor: 3.452
Authors: T Clark Powell; Sarah E Dilley; Sejong Bae; J Michael Straughn; Kenneth H Kim; Charles A Leath Journal: J Low Genit Tract Dis Date: 2018-10 Impact factor: 1.925
Authors: Michael D Toboni; Alexander Cohen; Zachary L Gentry; Stuart A Ostby; Zhixin Wang; Sejong Bae; Charles Leath Journal: Int J Gynecol Cancer Date: 2022-06-06 Impact factor: 4.661
Authors: Sarah C Markt; Tianyu Tang; Angel M Cronin; Ingrid T Katz; Brooke E Howitt; Neil S Horowitz; Larissa J Lee; Alexi A Wright Journal: PLoS One Date: 2018-02-15 Impact factor: 3.240