Bastin Nikita, Robinson Marc, Javid Amir, Prescott Lauren S, Brown Alaina J
Vanderbilt University School of Medicine, Nashville, TN, USA.
Vanderbilt University Medical Center, Nashville, TN, USA.
Gynecol Oncol Rep. 2025 Jul 20;60:101808. doi: 10.1016/j.gore.2025.101808. eCollection 2025 Aug.
To understand disparities in access to treatment for ovarian cancer patients.
A retrospective review of patients who had surgery for ovarian cancer at a comprehensive cancer center from 2018 to 2024 was completed. Social Vulnerability index quartiles generated by patients' zip codes were used as measures of social vulnerability. Social vulnerability encompasses four themes, including socioeconomic status, household characteristics, racial/ethnic minority status, and housing type and transportation. The primary outcome was time to treatment initiation. Secondary outcomes included time to chemotherapy, time to surgery, time to palliative care treatment, and progression-free survival. Logistic regression was used to assess the relationship between social vulnerability and treatment access.
Among 166 ovarian cancer patients, there was a trend towards increased time from diagnosis to treatment amongst patients with the highest social vulnerability (median 40 days) when compared to those with lower social vulnerability (median 22 - 27 days). When examining specific treatments received, patients with lower social vulnerability were more likely to experience shorter times to chemotherapy (median 29.5-32 days) when compared to patients with higher social vulnerability (median 41 - 45 days). Patients with the highest social vulnerability experienced the longest time to surgery (median 128 days) amongst all quartiles. There was a trend towards shorter times from diagnosis to palliative care consultation for patients of higher social vulnerability.
Higher social vulnerability was associated with longer times to curative treatment and shorter times to palliative care consultation among ovarian cancer patients. Further study in more diverse patient populations is necessary to ensure the equitable delivery of care in ovarian cancer.
了解卵巢癌患者在获得治疗方面的差异。
对2018年至2024年在一家综合癌症中心接受卵巢癌手术的患者进行了回顾性研究。将患者邮政编码生成的社会脆弱性指数四分位数用作社会脆弱性的衡量指标。社会脆弱性包括四个主题，即社会经济地位、家庭特征、种族/族裔少数群体地位以及住房类型和交通情况。主要结局是开始治疗的时间。次要结局包括开始化疗的时间、手术时间、姑息治疗开始时间和无进展生存期。采用逻辑回归评估社会脆弱性与治疗可及性之间的关系。
在166名卵巢癌患者中，社会脆弱性最高的患者（中位时间40天）从诊断到治疗的时间有增加趋势，而社会脆弱性较低的患者（中位时间22 - 27天）则不然。在检查接受的具体治疗时，社会脆弱性较低的患者与社会脆弱性较高的患者（中位时间41 - 45天）相比，更有可能经历较短的化疗时间（中位时间29.5 - 32天）。社会脆弱性最高的患者在所有四分位数中经历的手术时间最长（中位时间128天）。社会脆弱性较高的患者从诊断到姑息治疗咨询的时间有缩短趋势。
社会脆弱性较高与卵巢癌患者接受根治性治疗的时间较长和姑息治疗咨询的时间较短有关。有必要在更多样化的患者群体中进行进一步研究，以确保卵巢癌护理的公平提供。
