title: Racial disparities in surgical treatment and survival of epithelial ovarian cancer in United States.
abstract: OBJECTIVE
  To compare the racial differences in treatment and survival of epithelial ovarian cancer patients.
  
  
  METHODS
  Data were obtained from the Surveillance, Epidemiology, and End Results Program between 1988 and 2001 and analyzed using Kaplan-Meier methods and Cox proportional hazards regression.
  
  
  RESULTS
  Of the 24,038 women, 22,407 (93.2%) were non-Hispanic White, and 1,631 (6.8%) were African-American. Median age of Whites versus African-Americans was 65 versus 63 years, respectively (P < 0.001). Of the patients with early-stage (I-II) disease, 38.8% of Whites underwent lymphadenectomy with their primary surgery compared to only 32.8% of African-Americans (P = 0.005). In the overall study group, the 5-year disease-specific survival of Whites was significantly higher compared to the African-Americans (44.1% vs. 40.7%, P = 0.001). On multivariable analysis, age, race, stage, cell type, and grade of disease were all independent prognostic factors for survival.
  
  
  CONCLUSIONS
  Our data suggest that race is an independent prognostic factor for survival in epithelial ovarian cancer. In addition, African-Americans with early-stage cancer were less likely to undergo lymphadenectomy with their staging procedure. Furthermore, patient/physician education is needed to increase the number of patients undergoing surgical staging procedures for epithelial ovarian cancer.
authors.affiliation: Division of Gynecologic Oncology, Department of Obsetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco School of Medicine, UCSF Comprehensive Cancer Center, San Francisco, CA 94143-1702, USA. chanjohn@obgyn.ucsf.edu
authors.forename: John K
authors.initials: JK
authors.lastname: Chan
authors.forename: Mallory
authors.initials: M
authors.lastname: Zhang
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Hu
authors.forename: Jacob Y
authors.initials: JY
authors.lastname: Shin
authors.forename: Kathryn
authors.initials: K
authors.lastname: Osann
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Kapp
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000401:mortality / Q000601:surgery; D002288:Adenocarcinoma, Mucinous / Q000401:mortality / Q000601:surgery; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018269:Carcinoma, Endometrioid / Q000401:mortality / Q000601:surgery; D018283:Cystadenocarcinoma, Papillary / Q000401:mortality / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D008197:Lymph Node Excision / Q000706:statistics & numerical data; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011159:Population Surveillance; D011379:Prognosis; D018426:SEER Program; D015996:Survival Rate; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*