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堪萨斯州唯一一家由美国国立癌症研究所指定的癌症中心卵巢癌患者生存率的差异。

Disparities in ovarian cancer survival at the only NCI-designated cancer center in Kansas.

作者信息

Petersen Shariska, Shahiri Parmida, Jewell Andrea, Spoozak Lori, Chapman Julia, Fitzgerald-Wolff Sharon, Lai Sue Min, Khabele Dineo

机构信息

Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of Kansas Medical Center, Kansas City, KS, USA.

University of Kansas School of Medicine, University of Kansas Medical Center, Kansas City, KS, USA.

出版信息

Am J Surg. 2021 Apr;221(4):712-717. doi: 10.1016/j.amjsurg.2020.12.009. Epub 2020 Dec 7.

Abstract

BACKGROUND

This study examined the impact of geographic distance on survival outcomes for patients receiving treatment for ovarian cancer at the only NCI-designated cancer center (NCI-CC) in Kansas.

METHODS

We identified ovarian cancer patients treated at the University of Kansas Cancer Center between 2010 and 2015. Demographic factors and clinical characteristics were abstracted. The main outcome measure was overall survival according to geographic distance from the institution. Kaplan Meier survival curves and Cox proportional hazard models were generated using SAS v9.4.

RESULTS

220 patients were identified. Survival analysis based on distance from the institution demonstrated that patients who lived ≤10 miles from the institution had worse overall survival (p = 0.0207) and were more likely to have suboptimal cytoreductive surgery (p = 0.0276). Lower estimated median income was also associated with a 1.54 increased risk of death, 95% CI (1.031-2.292), p = 0.0347.

CONCLUSIONS

We determined that ovarian cancer survival disparities exist in our patient population. Lower rates of optimal cytoreductive surgery has been identified as a possible driver of poor prognosis for patients who lived in proximity to our institution.

摘要

背景

本研究调查了地理距离对堪萨斯州唯一一家美国国立癌症研究所指定癌症中心(NCI-CC)接受卵巢癌治疗患者生存结局的影响。

方法

我们确定了2010年至2015年间在堪萨斯大学癌症中心接受治疗的卵巢癌患者。提取了人口统计学因素和临床特征。主要结局指标是根据与该机构的地理距离得出的总生存期。使用SAS v9.4生成Kaplan Meier生存曲线和Cox比例风险模型。

结果

共确定了220例患者。基于与该机构距离的生存分析表明,居住在距离该机构≤10英里的患者总生存期较差(p = 0.0207),且更有可能接受次优细胞减灭术(p = 0.0276)。估计收入中位数较低也与死亡风险增加1.54倍相关,95%置信区间(1.031 - 2.292),p = 0.0347。

结论

我们确定在我们的患者群体中存在卵巢癌生存差异。已确定最佳细胞减灭术的较低实施率可能是居住在我们机构附近患者预后不良的一个驱动因素。

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