Abstract
Abstract only
e17508
Background: In high-risk early stage ovarian cancer, surgery followed by adjuvant chemotherapy demonstrates improved survival in prospective trials. The objective of this research was to document patterns of care in the treatment of stage II epithelial ovarian cancer and those factors associated with less than optimal treatment. Methods: The study population was selected from patients diagnosed with ovarian cancer in 2003 to 2005 and reported to the National Cancer Database, a hospital-based cancer registry. 2,252 (93.8%) patients had sufficient information for analysis. Demographics, health insurance, Charlson co-morbidity score, area-level income, and facility characteristics were analyzed as factors potentially associated with treatment. Multivariate logistic regression was performed to assess factors associated with optimal treatment versus suboptimal treatment. Results: Among the women 2,252 women included in the study 1,533 (68.0%) received surgery and chemotherapy and 719 (32.0%) received surgery alone. In multivariate analysis, Black and Hispanic patients were significantly less like likely to receive optimal treatment as compared to white patients (OR = 0.54, 95% CI 0.36–0.82; OR = 0.51, 95% CI = 0.34–0.79, respectively). Women 75 years of age or more were significantly less likely to receive optimal treatment (OR = 0.43 95% CI 0.28–0.67) compared to women less than 53 years. Treatment in a comprehensive cancer facility or teaching hospital compared to community cancer hospitals was positively associated with optimal treatment (OR = 1.40 95% CI 1.02–1.92; OR = 1.89 95% CI 1.38–2.59). Among the 719 patients not receiving chemotherapy, 205 had no reason recorded, and the majority with information (456/514) stated that chemotherapy was not part of planned therapy. Only 33 patients (6.4%) were recorded as refusing recommended chemotherapy. Conclusions: Although only a small proportion of newly diagnosed cases, Stage II ovarian cancer patients have a high probability of benefiting from adjuvant chemotherapy, which improves the likelihood of long-term survival and cure. Further studies are needed to address the patient, clinician and health system factors associated with suboptimal treatment.
No significant financial relationships to disclose.