The effect of Black versus White race on perceptions of care within a cohort of women treated for ovarian cancer at a high-volume cancer center

2021 ◽  
Vol 162 ◽  
pp. S289-S290
Author(s):  
Allison Saiz ◽  
Amy Alexander ◽  
Dominique Kinnett-Hopkins ◽  
Roya Zandi ◽  
Susan Folsom ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
High Volume ◽  
Cancer Center ◽  
White Race ◽  
Perceptions Of Care

Incorporation of HIPEC into a high volume ovarian cancer program: Initial results and outcomes.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17040-e17040
Author(s):  
Aliza L. Leiser ◽  
Eugenia Girda ◽  
Ruth D. Stephenson ◽  
Mihae Song ◽  
Alexandre Buckley de Meritens ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Progression Free Survival ◽  
High Volume ◽  
Cancer Center ◽  
R0 Resection ◽  
Consolidation Chemotherapy ◽  
Fallopian Tube Cancer ◽  
Primary Surgery ◽  
Cancer Program ◽  
To Receive

e17040 Background: HIPEC showed a progression free survival when incorporated into interval cytoreductive surgery for ovarian cancer patients in a recent phase lll trial. This has led to a paradigm shift at many institutions and the consideration of HIPEC. The goal of this study is to report on the initiation of this program and change in practice at a high volume cancer center over a period of 1 year. Methods: Reviewed surgical cases from 1/2018 through 1/2019 where patients were thought to have a primary ovarian or fallopian tube cancer. Variables included age, stage, histology, primary or interval debulking surgery, number of neoadjuvant (NAJ) chemotherapy cycles. HIPEC patients were selected out and variables examined included intraoperative procedures, optimal cytoreduction, type of chemotherapy administered, postoperative complications, and ability to receive consolidation chemotherapy. Results: 35 cases where ovarian cancer known or suspected preoperatively. 23 patients had primary surgery consisting of tah/bso/surgical staging/tumor debulking. 0/23 of these patients were offered HIPEC chemotherapy as an upfront strategy. 12 patients received neoadjuvant chemotherapy for recurrent (2) or advanced (10) disease. 11/12 of these patients proceeded to an interval surgery. 6/11 (54%) were planned for HIPEC. This was aborted in 1/6 because of thrombocytopenia. 5/6 patients went on to receive HIPEC. They received 3-6 cycles of NAJ chemotherapy, platinum and taxane. 3/5 also received preoperative Avastin. All had R0 resection. 1 patient had a bowel resection. Either carboplatin or cisplatin was used for HIPEC over 90 minutes. 2/5 patients had postoperative G2-3 cytopenias. 3/5 patients were able to receive consolidation chemotherapy, 2 of them within six weeks of surgery and with Avastin containing regimens. Conclusions: In a large volume center initiating a HIPEC ovarian cancer program in less than one years’ time, HIPEC was offered to 50% of patients undergoing interval debulking for Stage III or IV serous ovarian cancer after NAJ chemotherapy and in rare cases for patients with recurrent cancer planned for cytoreduction. Patients may go on to receive postoperative chemotherapy but may have prolonged cytopenias and consolidation therapy delays. HIPEC was not incorporated into an upfront surgical strategy.[Table: see text]

scholarly journals Factors Associated With Use of a High-Volume Cancer Center by Black Women With Ovarian Cancer

2019 ◽  
Vol 15 (9) ◽  
pp. e769-e776
Author(s):  
Renee A. Cowan ◽  
Elyse Shuk ◽  
Maureen Byrne ◽  
Nadeem R. Abu-Rustum ◽  
Dennis S. Chi ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Black Women ◽  
Insurance Coverage ◽  
High Volume ◽  
Cancer Center ◽  
Black Communities ◽  
Related Factors ◽  
Self Advocacy ◽  
Factors Affecting ◽  
Institutional Review

OBJECTIVE: Disparities exist between population subgroups in the use of gynecologic oncologists and high-volume hospitals. The objectives of this study were to explore the experiences of black women obtaining ovarian cancer (OC) care at a high-volume center (HVC) and to identify patient-, provider-, and systems-related factors affecting their access to and use of this level of care. MATERIALS AND METHODS: Twenty-one semistructured interviews were conducted as part of an institutional review board–approved protocol with women who self-identified as black or African American, treated for OC at a single HVC from January 2013 to May 2017. Recurring themes were identified in transcribed interviews through the process of independent and collaborative thematic content analysis. RESULTS: Five themes were identified: (1) internal attributes contributing to black women’s ability/desire to be treated at an HVC, (2) pathways to high- and low-volume centers, (3) obstacles to obtaining care, (4) potential barriers for black women interested in treatment at an HVC, and (5) suggestions for improving HVC use by black women. Study participants who successfully accessed care were comfortable navigating the health care system, understood the importance of self-advocacy, and valued the expertise of an HVC. Barriers to obtaining care at an HVC included lack of knowledge about the HVC, lack of referral, transportation difficulties, and lack of insurance coverage. CONCLUSION: In this qualitative study, black women treated at an HVC shared attributes and experiences that helped them access care. There is a need to collaborate with black communities and establish interventions to reduce barriers, facilitate access, and disseminate information about the value of receiving care for OC at an HVC.

Impact of geography and travel distance on outcomes in epithelial ovarian cancer: a national cancer database analysis

2020 ◽  
pp. ijgc-2020-001807
Author(s):  
Ava Daruvala ◽  
F Lee Lucas ◽  
Jesse Sammon ◽  
Christopher Darus ◽  
Leslie Bradford
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Healthcare Delivery ◽  
High Volume ◽  
Cox Proportional Hazards ◽  
Travel Distance ◽  
Cancer Center ◽  
National Cancer Database ◽  
Significant Difference ◽  
The Impact

BackgroundAs ovarian cancer treatment shifts to provide more complex aspects of care at high-volume centers, almost a quarter of patients, many of whom reside in rural counties, will not have access to those centers or receive guideline-based care.ObjectiveTo explore the association between proximity of residential zip code to a high-volume cancer center with mortality and survival for patients with ovarian cancer.MethodsThe National Cancer Database was queried for cases of newly diagnosed ovarian cancer between January 2004 and December 2015. Our predictor of interest was distance traveled for treatment. Our primary outcomes were 30-day mortality, 90-day mortality, and overall survival. The effect of treatment on survival was analyzed with the Kaplan-Meier method. Multiple logistic regression for binary outcomes and Cox proportional hazards regression for overall survival were used to assess the effect of distance on outcome, controlling for potential confounding variables.ResultsA total of 115 540 patients were included. There was no statistically significant difference in 30- or 90-day mortality among any of the travel distance categories. A statistically significant decrease in 30-day re-admission was found among patients who lived further away from the treating facility. A total of 105 529 patients were available for survival analysis, and survival curves significantly differed between distance strata (p<0.0001). The adjusted regression models demonstrated increased long-term mortality in patients who lived farther away from the treating facility after controlling for potential confounding.ConclusionAlthough 30- and 90-day mortality do not differ by travel distance, worse survival is observed among women living >50 miles from a high-volume treatment facility. With a national policy shift toward centralization of complex care, a better understanding of the impact of distance on survival in patients with ovarian cancer is crucial. Our findings inform the practice of healthcare delivery, especially in rural settings.

Factors associated with the access and use of a high-volume cancer center by black women with ovarian cancer: A qualitative study

2018 ◽  
Vol 149 ◽  
pp. 136
Author(s):  
R.A. Cowan ◽  
E. Shuk ◽  
M.E. Byrne ◽  
N.R. Abu-Rustum ◽  
D.S. Chi ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Black Women ◽  
Qualitative Study ◽  
High Volume ◽  
Cancer Center ◽  
Factors Associated

scholarly journals Adherence to French and ESGO Quality Indicators in Ovarian Cancer Surgery: An Ad-Hoc Analysis from the Prospective Multicentric CURSOC Study

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1593
Author(s):  
Alejandra Martinez ◽  
Witold Gertych ◽  
Christophe Pomel ◽  
Gwenael Ferron ◽  
Amelie Lusque ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Quality Indicators ◽  
Ad Hoc ◽  
Randomized Study ◽  
Institutional Quality ◽  
High Volume ◽  
Cost Utility ◽  
Case Volume ◽  
Tertiary Institutions ◽  
The Cost

Background: Quality Indicators for ovarian cancer (OC) have been developed by the European Society of Gynaecological Oncology (ESGO) and by the French National Cancer Institute (Institut National du Cancer, INCa). The aim of the study was to characterize OC care distribution in France by case-volume and to prospectively evaluate the adherence of high-volume institutions to INCa/ESGO quality indicators. Methods: The cost-utility of radical surgery in ovarian cancer (CURSOC) trial is a prospective, multicenter, comparative and non-randomized study that includes patients with stage IIIC-IV epithelial OC treated in nine French health care tertiary institutions. Adherence to institutional quality indicators were anonymously assessed by an independent committee. OC care distribution in France were provided by the nationwide database of hospital procedures. Results: More than half of patients are treated in low-volume institutions. Among the nine high-volume centers participating in the study, four (44.4%) met all institutional INCa/ESGO quality indicators. The other five (55.6%) did not fulfil one of the quality indicator criteria. Conclusions: Access to high-volume OC providers in France is restricted to a minority of patients, and yet half of the referral institutions included in this study failed to meet all recommended institutional quality indicators. It is mandatory that national authorities work both to improve OC centralization and to incorporate quality assurance programs into certified centers.

Educational system for acquiring appropriate laparoscopic colorectal surgical skills: analysis in a Japanese high-volume cancer center

2020 ◽  
Author(s):  
Ryota Nakanishi ◽  
Yosuke Fukunaga ◽  
Toshiki Mukai ◽  
Toshiya Nagasaki ◽  
Tomohiro Yamaguchi ◽  
...  
Keyword(s):  
Educational System ◽  
High Volume ◽  
Surgical Skills ◽  
Cancer Center

scholarly journals High volume pancreaticoduodenectomy performed at a community cancer center

HPB ◽  
2018 ◽  
Vol 20 ◽  
pp. S38-S39
Author(s):  
A. Sabesan ◽  
B. Gough ◽  
C. Anderson ◽  
R. Abdel-Misih ◽  
N.J. Petrelli ◽  
...  
Keyword(s):  
High Volume ◽  
Cancer Center

scholarly journals Incidence, characteristics, pattern and management of ovarian cancer in Abuja, Nigeria

2020 ◽  
Vol 8 (9) ◽  
pp. 3187
Author(s):  
Malachy Emeka Ayogu ◽  
Habiba Ibrahim Abdullahi ◽  
Innocent O. Eze
Keyword(s):  
Ovarian Cancer ◽  
Relevant Information ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Advanced Stage ◽  
Survival Times ◽  
Pattern Of Care ◽  
Ovarian Cancers ◽  
Compliance To Treatment ◽  
Lost To Follow Up

Background: The prevalence of ovarian cancer is thought to be increasing with huge burden of the disease with no comprehensive cancer center that can offer appropriate care in developing countries. However, little is known about the incidence, pattern and outcome of this disease in Abuja, Nigeria. Therefore, the aim of this study was to review the pattern of care offered to patients with ovarian cancer in our center and to evaluate patients’ outcome.Methods: This was a retrospective review of all the patients with histologically confirmed ovarian cancers admitted to the gynecological ward of the hospital over a period of 5 years. Relevant information was extracted from the ward register and patients medical case records. Data were analyzed using statistical package for social science version 23 and results were then presented in tables and chart.Results: Ovarian cancers constituted 19.6% and 5.6% of all gynecological cancers and all gynecological admissions respectively. The mean age at presentation was 50.2±8.5 years and premenopausal 32 (55%) constituting the majority. A large proportion 43 (74.1%) of the patients were parous. The commonest symptoms at presentation were abdominal swelling (86.2%), and abdominal pain (53.4%) with the majority 38 (65.5%) presenting in an advanced stage. The commonest histological type of ovarian cancers was epithelial accounting for 30 (51.7%) of all ovarian cancers. Common treatment modality was surgery and chemotherapy and majority 32 (55.3%) of the patients had cytoreductive surgery with 19 of them having optimum cytoreduction and 33 (57%) benefitted from chemotherapy. Lost to follow- up was significantly high (55%) and mortality rate was 15.5%.Conclusion: Cases of ovarian cancers are on the increase. Women presented at an advanced stage of the disease, which resulted in short survival times. Failure of optimal management was also worsened by poor compliance to treatment with high patients' default rate.

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