Self-identification by Jewish religion: Lack of association with overall survival in ovarian cancer at Memorial Sloan-Kettering Cancer Center from 1998 to 2006.

Abstract

e15552 Background: There is up to a 25% incidence of the 3 founder BRCA 1 and 2 mutations in unselected Ashkenazi Jewish ovarian cancer (OC) pts. Survival of pts with BRCA-associated advanced-stage OC is longer than that of matched controls. We examined the hypothesis: self-identification as Jewish (J) might serve as a surrogate marker for improved survival for OC pts. Methods: This is a single-institution retrospective analysis of pts from the MSKCC database between 01/01/98 and 01/24/06 with a histologic diagnosis of epithelial ovarian, or primary peritoneal cancer, and a stated religion, for whom follow-up data were available. IRB waiver was obtained for chart review. Data were collected on diagnosis, dates of surgery, recurrence, chemo, and death, as well as CA-125 nadir. The primary endpoint was OS. The date of initial surgery was used to calculate OS according to date of death or most recent follow-up. Stage and histology were obtained from pathology reports and operative notes, categorized according to ISGO and WHO standards. Kaplan-Meier estimates of OS stratified by various prognostic factors were calculated and compared by means of the log rank test statistic in the univariate setting. Multivariate Cox regression models were used to assess the association between survival and religion. All analyses were conducted using SAS version 9.0 (SAS Institute, Carey, North Carolina). Results: 1,601 pts with OC were identified across all stages. 307 (19%) were self-identified as J. Median FU for survivors was 2.9 yrs (range 0-29.9). Median OS was 6 yrs CI (5.6- 6.7). The median OS for J pts across all stages was 5.8 yrs, and 6.8 yrs for non-J identified pts. The 5 year OS rate was 59% for J pts and 56% for non-J (p = 0.72). Among the 1,193 (74.5%) pts with high-stage disease (stage III or IV), median OS for J pts was 5.4 yrs, and 5.0 yrs for non-J identified pts and the 5 yr OS rate was 56% for J pts and 50% for non-J (p = 0.42). Conclusions: In our review of a large series of OC pts, self-identification as J was not an independent predictor of increased OS. A possible weakness of this study was the reliance on self-reporting to identify J pts, and the reporting did not discriminate between Ashkenazi and other J groups. No significant financial relationships to disclose.