Racial disparities in surgical treatment and survival of epithelial ovarian cancer in United States

Journal of Surgical Oncology (Impact Factor: 3.24). 02/2008; 97(2):103 - 107. DOI: 10.1002/jso.20932


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.ResultsOf 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. J. Surg. Oncol. 2008;97:103–107. © 2007 Wiley-Liss, Inc.

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    • "Further analysis of the cohort shows that a statistically significantly larger proportion of Hispanic women underwent staging lymphadenectomy as part of their treatment. The prognostic effect of lymphadenectomy in early stage ovarian cancer is well known [15]. The higher frequency of lymphadenectomy in Hispanics is unexplained but suggests more frequent use of complete staging procedures among Hispanics as a proxy measure of health process measure. "
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