Pattern of Care, Health Care Disparities, and Their Impact on Survival Outcomes in Stage IVB Cervical Cancer: A Nationwide Retrospective Cohort Study

International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society
Randa J JalloulMichelle S Ludwig

Abstract

Although locally advanced cervical cancer can be cured, patients with stage IVB disease have poor prognosis with limited treatment options. Our aim was to describe the pattern of care and analyze health disparity variables that may account for differences in treatment modalities and survival in this population. The National Cancer Database was queried for patients diagnosed between 2004 and 2013 with metastatic squamous cell carcinoma or adenocarcinoma of the cervix. Codes representing parenchymal and lymphatic metastasis (beyond the para-aortic radiation fields) were used to identify the cohort. Variables included age, race, insurance status, comorbidity, treatment modality, and outcomes. We used Kaplan-Meier methods to compare survival curves and Cox proportional hazards to estimate the association between variables and overall survival (OS). Log-rank method was used to compare Kaplan-Meier curves. There were 4576 patients identified. The majority was white (59.7%); 19.5% were Hispanic, and 9.6% were black. Fifty-one percent had Medicare/Medicaid; 33.7% had private, and 12.5% had no insurance. The majority (56.3%) received chemotherapy (CMT) alone or in combination with radiation therapy (RT) and/or surgery. Median follow-up ...Continue Reading

References

Jun 1, 1992·Journal of Clinical Epidemiology·R A DeyoM A Ciol
Dec 13, 2006·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·M A QuinnS Pecorelli
Mar 21, 2007·Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology·Joellen M SchildkrautAndrew Berchuck
Jun 5, 2007·Current Problems in Cancer·Aletha Y AkersJennifer S Smith
Jun 14, 2008·Gynecologic Oncology·Levi S DownsGroesbeck Parham
May 26, 2009·Journal of Surgical Oncology·Mehul V RavalClifford Y Ko
Jun 7, 2012·Gynecologic Oncology·Kristy K WardSteven C Plaxe
Jun 30, 2012·American Journal of Public Health·Stacey A FedewaElizabeth M Ward
Sep 5, 2012·Chinese Journal of Cancer·Hui-Juan Yang
Nov 21, 2012·Journal of Health Care for the Poor and Underserved·Charles E MooreSandy D Maclin
Mar 27, 2013·Journal of Lower Genital Tract Disease·L Stewart MassadUNKNOWN 2012 ASCCP Consensus Guidelines Conference
Aug 10, 2013·Cancer Medicine·Xiaoling NiuKevin A Henry
Jan 9, 2014·CA: a Cancer Journal for Clinicians·Rebecca SiegelAhmedin Jemal
Feb 21, 2014·The New England Journal of Medicine·Krishnansu S TewariBradley J Monk
Aug 17, 2014·Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health·F Benjamin Zhan, Yan Lin
Feb 20, 2015·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Emma Altobelli, Amedeo Lattanzi
Aug 14, 2015·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Gillian L HsiehMichelle S Ludwig
Nov 11, 2015·Annals of Epidemiology·Van T NghiemScott B Cantor
Dec 30, 2015·Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology·Sharon R PineCurtis C Harris
Apr 26, 2016·PloS One·Xuefeng WangJennie L Williams
Nov 1, 2006·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·M A QuinnS Pecorelli

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Citations

Dec 21, 2019·Journal of Palliative Medicine·Maria Caterina PallottiAntonio Noguera
Aug 28, 2021·International Journal of Environmental Research and Public Health·Eun-Mi BaekEun-Jung Kwon

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