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Socioeconomic differences impact overall survival in advanced ovarian cancer (AOC) prior to achievement of standard therapy.

Authors :
Phillips, Andrew
Kehoe, Sean
Singh, Kavita
Elattar, Ahmed
Nevin, James
Balega, Janos
Pounds, Rachel
Elmodir, Ahmed
Pascoe, Jennifer
Fernando, Indrajit
Sundar, Sudha
Source :
Archives of Gynecology & Obstetrics. Nov2019, Vol. 300 Issue 5, p1261-1270. 10p. 1 Chart, 4 Graphs.
Publication Year :
2019

Abstract

<bold>Purpose: </bold>Survival difference between socioeconomic groups with ovarian cancer has persisted in the United Kingdom despite efforts to reduce disparities in care. Our aim was to delineate critical episodes in the patient journey, where deprivation has most impact on survival.<bold>Methods: </bold>A retrospective review of 834 patients with advanced ovarian cancer (AOC) between 16/8/07-16/2/17 at a large cancer centre serving one of the most deprived areas of the UK. Using the Index of Multiple Deprivation (IMD), patients were categorised into five groups.<bold>Results: </bold>Surgery was more common in less deprived patients (p < 0.00001). Across IMD groups, there were no differences in complete (R0) cytoreduction rate (r = 0.18, p > 0.05), age, or comorbidity. The R0/total cohort rate increased with increasing IMD group (p < 0.0001). Patients refusing any intervention belonged exclusively to the three most deprived groups; 5/7 patients who refused surgery belonged to the most deprived IMD group. Overall survival in the total patient group was less in IMD group 1-2 compared to 9-10 (p = 0.002). On multivariate analysis, IMD group was not an independent predictor of survival (p > 0.05).<bold>Conclusions: </bold>Socioeconomic differences in survival manifest in patients not receiving surgical treatment for AOC and are not purely explained by comorbidity, age, stage, or histological factors. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
09320067
Volume :
300
Issue :
5
Database :
Academic Search Index
Journal :
Archives of Gynecology & Obstetrics
Publication Type :
Academic Journal
Accession number :
139315649
Full Text :
https://doi.org/10.1007/s00404-019-05269-8