Details:

Alternative Title:
World J Obstet Gynecol
Personal Author:
Rim, Sun Hee; Hirsch, Shawn; Thomas, Cheryll C.; Brewster, Wendy R.; Cooney, Darryl; ... More +
Rim, Sun Hee; Hirsch, Shawn; Thomas, Cheryll C.; Brewster, Wendy R.; Cooney, Darryl; Thompson, Trevor D.; Stewart, Sherri L.; Less -
Description:
AIM To examine the influence of gynecologic oncologists (GO) in the United States on surgical/chemotherapeutic standard of care (SOC), and how this translates into improved survival among women with ovarian cancer (OC). METHODS Surveillance, Epidemiology, and End Result (SEER)-Medicare data were used to identify 11688 OC patients (1992–2006). Only Medicare recipients with an initial surgical procedure code (n = 6714) were included. Physician specialty was identified by linking SEER-Medicare to the American Medical Association Masterfile. SOC was defined by a panel of GOs. Multivariate logistic regression was used to determine predictors of receiving surgical/chemotherapeutic SOC and proportional hazards modeling to estimate the effect of SOC treatment and physician specialty on survival. RESULTS About 34% received surgery from a GO and 25% received the overall SOC. One-third of women had a GO involved sometime during their care. Women receiving surgery from a GO vs non-GO had 2.35 times the odds of receiving the surgical SOC and 1.25 times the odds of receiving chemotherapeutic SOC (P < 0.01). Risk of mortality was greater among women not receiving surgical SOC compared to those who did [hazard ratio = 1.22 (95%CI: 1.12–1.33), P < 0.01], and also was higher among women seen by non-GOs vs GOs (for surgical treatment) after adjusting for covariates. Median survival time was 14 mo longer for women receiving combined SOC. CONCLUSION A survival advantage associated with receiving surgical SOC and overall treatment by a GO is supported. Persistent survival differences, particularly among those not receiving the SOC, require further investigation.
Subject:
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And End Result Medicare
Article
Epidemiology
Guidelines-based Care
Gynecologic Oncologist
Ovarian Neoplasms
Surveillance

Source:
World J Obstet Gynecol. 5(2):187-196.;
Pubmed ID:
29520338
Pubmed Central ID:
PMC5839163
Document Type:
Journal Article;
Funding:
CC999999/Intramural CDC HHS/United States;
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:d80e1a07206502a845f22b58bc09ec919ae69b5437fc75c16b2e0d4e8e54638b
File Type:

Supporting Files

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