Racial disparities in surgical treatment and survival of epithelial ovarian cancer in United States

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. Conclusion: 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.