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

Research output: Contribution to journalArticle


  • Andrew Phillips
  • Kavita Singh
  • Ahmed Elattar
  • James Nevin
  • Janos Balega
  • Rachel Pounds
  • Ahmed Elmodir
  • Jennifer Pascoe
  • Indrajit Fernando

Colleges, School and Institutes

External organisations

  • Royal Derby Hospital
  • Birmingham City Hospital
  • Pan-Birmingham Gynaecological Cancer Centre
  • Queen Elizabeth Hospital, University Hospital Birmingham NHS Foundation Trust


Purpose: 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. Methods: 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. Results: 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). Conclusions: 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.


Original languageEnglish
Pages (from-to)1261-1270
Number of pages10
JournalArchives of Gynecology and Obstetrics
Issue number5
Publication statusPublished - 1 Nov 2019


  • Cancer, Charlson, Cytoreduction, Deprivation, Ovarian

ASJC Scopus subject areas