title: Survival differences of Asian and Caucasian epithelial ovarian cancer patients in the United States.
abstract: OBJECTIVE
  To compare the racial differences in treatment and survival of Asian-Americans and White patients with epithelial ovarian cancer.
  
  
  METHODS
  Data were obtained from the Surveillance, Epidemiology, and End Results Program between 1988 and 2009 and analyzed using Chi-squared tests, Kaplan-Meier methods, and Cox regression analysis.
  
  
  RESULTS
  Of the 52,260 women, 3932 (7.5%) were coded as Asian, and 48,328 (92.5%) were White. The median age of Asians at diagnosis was 56 vs. 64 years for the Whites (p<0.001). Asians were more likely to undergo primary surgery, have an earlier stage of disease, have a diagnosis of a non-serous histology, and have lower grade tumors. The 5-year disease-specific survival (DSS) of Asians was higher compared to Whites (59.1% vs. 47.3%, p<0.001). On a subset analysis, Vietnamese, Filipino, Chinese, Korean, Japanese, and Asian Indian/Pakistani ethnicities had 5-year DSS of 62.1%, 61.5%, 61.0%, 59.0%, 54.6%, and 48.2%, respectively (p=0.015). On multivariate analysis, age at diagnosis, year of diagnosis, race, surgery, stage, and tumor grade were all independent prognostic factors for survival. Asians were further stratified to U.S. born versus those who were born in Asia and immigrated. Asian immigrants presented at a younger age compared to U.S. born Asians. Immigrants were found to have an improved 5-year DSS when compared to U.S. born Asians and Whites of 55%, 52%, and 48%, respectively (p<0.001).
  
  
  CONCLUSIONS
  Asians were more likely to be younger, undergo primary surgery, have an earlier stage of disease, non-serous histology, lower grade tumors, and higher survival.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, 1600 Divisadero Street, San Francisco, CA 94143-1702, USA.
authors.forename: Katherine C
authors.initials: KC
authors.lastname: Fuh
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, 1600 Divisadero Street, San Francisco, CA 94143-1702, USA.
authors.forename: Jacob Y
authors.initials: JY
authors.lastname: Shin
authors.affiliation: Department of Radiation Oncology, Stanford University, 400 Pasteur Drive, Stanford, CA 94305, USA.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Kapp
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, 1600 Divisadero Street, San Francisco, CA 94143-1702, USA.
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Brooks
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, 1600 Divisadero Street, San Francisco, CA 94143-1702, USA.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Ueda
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Washington Medical Center, 1959 NE Pacific Street, Seattle, WA 98195-6460, USA.
authors.forename: Renata R
authors.initials: RR
authors.lastname: Urban
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, 1600 Divisadero Street, San Francisco, CA 94143-1702, USA.
authors.forename: Lee-May
authors.initials: LM
authors.lastname: Chen
authors.affiliation: Division of Gynecologic Oncology, California Pacific & Palo Alto Medical Foundation/Research Institute, Sutter Cancer Research Consortium, 3838 California Street #410, San Francisco, CA 94115, USA. Electronic address: chanjohn@sutterhealth.org.
authors.forename: John K
authors.initials: JK
authors.lastname: Chan
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian; D000077216:Carcinoma, Ovarian Epithelial; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D015999:Multivariate Analysis; D009375:Neoplasms, Glandular and Epithelial / Q000208:ethnology / Q000401:mortality* / Q000601:surgery; D010051:Ovarian Neoplasms / Q000208:ethnology / Q000401:mortality* / Q000601:surgery; D011379:Prognosis; D016016:Proportional Hazards Models; D018426:SEER Program; D015996:Survival Rate; D014481:United States / Q000453:epidemiology; D044465:White People
keywords: Immigrants; Ovarian cancer; Racial differences; Survival outcomes