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

Authors

  • John K. Chan MD,

    Corresponding author
    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, California
    • Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, San Francisco School of Medicine, University of California, San Francisco Comprehensive Cancer Center, 1600 Divisadero Street Box 1702, San Francisco, CA 94143-1702. Fax: 415-885-3586.
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  • Mallory Zhang MD,

    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, California
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  • Jessica M. Hu BA,

    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, California
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  • Jacob Y. Shin BA,

    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, California
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  • Kathryn Osann PhD,

    1. Division of Hematology and Oncology, Department of Medicine, Chao Family Comprehensive Cancer Center, University of California, Irvine—Medical Center, Orange, California
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  • Daniel S. Kapp MD, PhD

    1. Division of Radiation Therapy, Department of Radiation Oncology, Stanford University School of Medicine, Stanford Cancer Center, Stanford, California
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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. J. Surg. Oncol. 2008;97:103–107. © 2007 Wiley-Liss, Inc.

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