Quality and outcomes of hysterectomy performed at low-income hospitals for patients with apparent early-stage endometrial cancer

Objectives: Evaluate the outcomes of hysterectomy for apparent early stage endometrial carcinoma performed at low-income hospitals. Methods: Patients diagnosed between 2004 and 2016 with an uterine, cervical or ovarian tumor with known insurance status were drawn from the National Cancer Database. Low-income hospitals (LIH) were determined as those with the highest percentage (>75th percentile) of uninsured or Medicaid patients. Hospitals with lowest percentage ( Results: A total of 1237 facilities who reported patients with gynecologic malignancies were identified. The average percentage of uninsured or Medicaid patients at LIH was 25.3% compared to 4.54% for non-LIH. A total of 53500 patients with apparent early stage endometrial carcinoma who met the inclusion criteria were identified; 40.3% were managed at a LIH. Compared to patients having surgery at a non-LIH, those undergoing hysterectomy at a LIH were younger (median 61 vs 62 years, p Conclusions: Patients with apparent early stage endometrial cancer undergoing surgery at a LIH have lower access to MIS techniques and increased peri-operative morbidity compared to those managed at non-LIH. A small increase in overall mortality was also noted.