Gynecologic oncologist impact on adjuvant chemotherapy care for stage II-IV ovarian cancer patients
| Autor: | Charles F. Lynch, Mary E. Charlton, Michael O'Rorke, Sherri L. Stewart, Michele M. West, Megan E McDonald, Ryan M. Carnahan, Jacob Oleson, Kristin S. Weeks |
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| Rok vydání: | 2022 |
| Předmět: |
Adult
Rural Population medicine.medical_specialty Adolescent medicine.medical_treatment Antineoplastic Agents Health Services Accessibility Medical Records Midwestern United States Cohort Studies Young Adult medicine Humans Practice Patterns Physicians' Stage (cooking) Aged Neoplasm Staging Proportional Hazards Models Retrospective Studies Aged 80 and over Oncologists Ovarian Neoplasms Chemotherapy business.industry Proportional hazards model Medical record General surgery Obstetrics and Gynecology Retrospective cohort study Odds ratio Middle Aged medicine.disease Oncology Chemotherapy Adjuvant Female Ovarian cancer business Gynecologic Oncologist |
| Zdroj: | Gynecologic Oncology. 164:3-11 |
| ISSN: | 0090-8258 |
| DOI: | 10.1016/j.ygyno.2021.11.001 |
| Popis: | Objective We aim to evaluate the impact gynecologic oncologists have on ovarian cancer adjuvant chemotherapy care from their role as surgeons recommending adjuvant chemotherapy care and their role as adjuvant chemotherapy providers while considering rural-urban differences. Methods Multivariable adjusted logistic regressions and Cox proportional hazards models were developed using a population-based, retrospective cohort of stage II-IV and unknown stage ovarian cancer patients diagnosed in Iowa, Kansas, and Missouri in 2010–2012 whose medical records were abstracted in 2017–2018. Results Gynecologic oncologist surgeons (versus other type of surgeon) were associated with increased odds of adjuvant chemotherapy initiation (adjusted odds ratio (OR) 2.18; 95% confidence interval (CI) 1.10–4.33) and having a gynecologic oncologist adjuvant chemotherapy provider (OR 10.0; 95% CI 4.58–21.8). Independent of type of surgeon, rural patients were less likely to have a gynecologic oncologist chemotherapy provider (OR 0.52; 95% CI 0.30–0.91). Gynecologic oncologist adjuvant chemotherapy providers (versus other providers) were associated with decreased surgery-to-chemotherapy time (rural: 6 days; urban: 8 days) and increased distance to chemotherapy (rural: 22 miles; urban: 11 miles). Rural women (versus urban) traveled 38 miles farther when their chemotherapy provider was a gynecologic oncologist and 27 miles farther when it was not. Conclusion Gynecologic oncologist surgeons may impact adjuvant chemotherapy initiation. Gynecologic oncologists serving as adjuvant chemotherapy providers were associated with some care benefits, such as reduced time from surgery-to-chemotherapy, and some care barriers, such as travel distance. The barriers and benefits of having a gynecologic oncologist involved in adjuvant chemotherapy care, including rural-urban differences, warrant further research in other populations. |
| Databáze: | OpenAIRE |
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