Does equal treatment yield equal outcomes? The impact of race on survival in epithelial ovarian cancer

Abstract

ObjectiveTo determine if race impacts the survival of patients with epithelial ovarian cancer in a large academic medical center. MethodsDemographic and clinical–pathologic information from patients treated at the University of Chicago from 1992–2007 were analyzed. Continuous variables were analyzed with t tests and categorical variables with chi square tests. Survival curves were evaluated using Kaplan–Meier methods and Cox proportional hazard models were constructed for both overall and disease free survival. Results209 women with epithelial ovarian cancer were included in the study, 163 (78%) white and 46 (22%) African American. The baseline demographic characteristics and clinico-pathologic factors such as disease stage, grading, CA-125 levels, rates of optimal debulking (<1 cm residual tumor), platinum sensitivity and American Society of Anesthesiologists score (ASA) were similar between the groups. The median overall survival for African American women was similar: 37.2 months (95% Confidence Interval (CI): 22.5, 52.9) while it was 34.1 months (95% CI: 27.4, 42.6) for white women. ConclusionsThere is no evidence of a racial disparity in either treatment or survival for ovarian cancer patients treated at a large academic center. Given that large epidemiologic studies suggested a difference in survival between African American and white women, other sources of disparities must be sought.