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

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Socioeconomic differences impact overall survival in advanced ovarian cancer (AOC) prior to achievement of standard therapy. / Phillips, Andrew; Kehoe, Sean; Singh, Kavita; Elattar, Ahmed; Nevin, James; Balega, Janos; Pounds, Rachel; Elmodir, Ahmed; Pascoe, Jennifer; Fernando, Indrajit; Sundar, Sudha.

In: Archives of Gynecology and Obstetrics, Vol. 300, No. 5, 01.11.2019, p. 1261-1270.

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Phillips, Andrew ; Kehoe, Sean ; Singh, Kavita ; Elattar, Ahmed ; Nevin, James ; Balega, Janos ; Pounds, Rachel ; Elmodir, Ahmed ; Pascoe, Jennifer ; Fernando, Indrajit ; Sundar, Sudha. / Socioeconomic differences impact overall survival in advanced ovarian cancer (AOC) prior to achievement of standard therapy. In: Archives of Gynecology and Obstetrics. 2019 ; Vol. 300, No. 5. pp. 1261-1270.

Bibtex

@article{ace1e05bc3f1495b91377a97ac0037b2,
title = "Socioeconomic differences impact overall survival in advanced ovarian cancer (AOC) prior to achievement of standard therapy",
abstract = "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.",
keywords = "Cancer, Charlson, Cytoreduction, Deprivation, Ovarian",
author = "Andrew Phillips and Sean Kehoe and Kavita Singh and Ahmed Elattar and James Nevin and Janos Balega and Rachel Pounds and Ahmed Elmodir and Jennifer Pascoe and Indrajit Fernando and Sudha Sundar",
year = "2019",
month = nov,
day = "1",
doi = "10.1007/s00404-019-05269-8",
language = "English",
volume = "300",
pages = "1261--1270",
journal = "Archives of Gynecology and Obstetrics",
issn = "0932-0067",
publisher = "Springer",
number = "5",

}

RIS

TY - JOUR

T1 - Socioeconomic differences impact overall survival in advanced ovarian cancer (AOC) prior to achievement of standard therapy

AU - Phillips, Andrew

AU - Kehoe, Sean

AU - Singh, Kavita

AU - Elattar, Ahmed

AU - Nevin, James

AU - Balega, Janos

AU - Pounds, Rachel

AU - Elmodir, Ahmed

AU - Pascoe, Jennifer

AU - Fernando, Indrajit

AU - Sundar, Sudha

PY - 2019/11/1

Y1 - 2019/11/1

N2 - 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.

AB - 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.

KW - Cancer

KW - Charlson

KW - Cytoreduction

KW - Deprivation

KW - Ovarian

UR - http://www.scopus.com/inward/record.url?scp=85071027415&partnerID=8YFLogxK

U2 - 10.1007/s00404-019-05269-8

DO - 10.1007/s00404-019-05269-8

M3 - Article

C2 - 31414175

AN - SCOPUS:85071027415

VL - 300

SP - 1261

EP - 1270

JO - Archives of Gynecology and Obstetrics

JF - Archives of Gynecology and Obstetrics

SN - 0932-0067

IS - 5

ER -