Exploring the impact of income and race on survival for women with advanced ovarian cancer undergoing primary debulking surgery at a high-volume center Journal Article


Authors: Cowan, R. A.; Tseng, J.; Ali, N.; Dearie, H.; Murthy, V.; Gennarelli, R. L.; Iasonos, A.; Abu-Rustum, N. R.; Chi, D. S.; Long Roche, K. C.; Brown, C. L.
Article Title: Exploring the impact of income and race on survival for women with advanced ovarian cancer undergoing primary debulking surgery at a high-volume center
Abstract: Objective: To evaluate patients with advanced ovarian cancer (OC) undergoing primary debulking surgery (PDS) at a high-volume center (HVC), to determine whether socio-demographic disparities in PDS outcome and overall survival (OS) were present. Methods: All patients with stages IIIB-IV high-grade OC undergoing PDS at our institution from 1/2001–12/2013 were identified. Patients self-identified race/ethnicity as non-Hispanic White (NHW), non-Hispanic Black (NHB), Asian (A), or Hispanic (H). Income level for the entire cohort was estimated using the census-reported income level for each patient's zip code as a proxy for SES. Main outcome measures were PDS outcome and median OS. Cox proportional hazards model was used to examine differences in OS by racial/ethnic and income category, controlling for selected clinical factors. Results: 963 patients were identified for analysis: 855 NHW; 43 A, 34H, 28 NHB, and 3 unknown. PDS outcome was not significantly different among NHB and H as compared to NHW. Compared to NHW, Asians were more likely to have > 1 cm residual (AOR 2.32, 95%CI 1.1–4.9, p = 0.03). Median income for the entire cohort was $85,814 (range $10,926–$231,667). After adjusting for significant prognostic factors, there were no significant differences in PDS outcome between income groups (p = 0.7281). Median OS was 55.1mos (95%CI 51.8–58.5) with no significant differences in OS between the income (p = 0.628) or racial/ethnic (p = 0.615) groups. Conclusion: Statistically significant socio-demographic disparities in PDS and survival outcomes were not observed among women with advanced OC treated at this HVC. Increased efforts are needed to centralize care to and increase the diversity of pts treated at HVCs. © 2017
Keywords: ovarian cancer; racial disparities; high volume centers; income disparities
Journal Title: Gynecologic Oncology
Volume: 149
Issue: 1
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2018-04-01
Start Page: 43
End Page: 48
Language: English
DOI: 10.1016/j.ygyno.2017.11.012
PROVIDER: scopus
PUBMED: 29605049
DOI/URL:
Notes: Article -- Export Date: 2 April 2018 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Carol Brown
    121 Brown
  2. Dennis S Chi
    496 Chi
  3. Alexia Elia Iasonos
    179 Iasonos
  4. Kara Christine Long
    55 Long
  5. Narisha   Ali
    5 Ali
  6. Jill   Tseng
    17 Tseng
  7. Renee Antonette Woodburn Cowan
    11 Cowan
  8. Helen Farrell Dearie
    1 Dearie