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Abstract：
Our objective was to evaluate racial treatment and survival disparities in black women with ovarian cancer in the Deep South and to determine how environmental factors / socioeconomic status (SES) influence survival.
A retrospective study of ovarian cancer patients from 2007 to 2014 was performed. Socioeconomic status (SES) was obtained though U.S. Census block data and compared using Yost scores. Comparisons were performed using standard statistical approaches.
A total of 393 patients were evaluated, 325 (83%) white and 68 (17%) black. Demographic information and surgical approach were similar in each racial group. However, compared to whites, black patients had lower rates of optimal debulking [89% vs. 71%, respectively (p=0.001)] and intraperitoneal chemotherapy (19% vs. 11%, p=0.01). Black women had lower SES parameters including education, income, and poverty. As a result, more black patients had the lowest SES (SES-1) when compared to white patients (17% vs. 41%, p<0.001). When controlling for these factors by cox regression analysis, a survival disadvantage was seen in black women for both progression free survival (16 vs. 27months, p=0.003) and overall survival (42 vs. 88months, p<0.001).
Despite controlling for clinical and environmental factors, a survival disadvantage was still observed in black patients with ovarian cancer in the Deep South. Black women had lower optimal debulking rates and more platinum resistant disease. These data suggest other factors like tumor biology may play a role in racial survival differences, however, more research is needed to determine this causation.
A retrospective study of ovarian cancer patients from 2007 to 2014 was performed. Socioeconomic status (SES) was obtained though U.S. Census block data and compared using Yost scores. Comparisons were performed using standard statistical approaches.
A total of 393 patients were evaluated, 325 (83%) white and 68 (17%) black. Demographic information and surgical approach were similar in each racial group. However, compared to whites, black patients had lower rates of optimal debulking [89% vs. 71%, respectively (p=0.001)] and intraperitoneal chemotherapy (19% vs. 11%, p=0.01). Black women had lower SES parameters including education, income, and poverty. As a result, more black patients had the lowest SES (SES-1) when compared to white patients (17% vs. 41%, p<0.001). When controlling for these factors by cox regression analysis, a survival disadvantage was seen in black women for both progression free survival (16 vs. 27months, p=0.003) and overall survival (42 vs. 88months, p<0.001).
Despite controlling for clinical and environmental factors, a survival disadvantage was still observed in black patients with ovarian cancer in the Deep South. Black women had lower optimal debulking rates and more platinum resistant disease. These data suggest other factors like tumor biology may play a role in racial survival differences, however, more research is needed to determine this causation.
摘要：
我们的目标是评估深南地区黑人卵巢癌妇女的种族治疗和生存差异，并确定环境因素/社会经济地位（SES）如何影响生存。
对2007年至2014年的卵巢癌患者进行了回顾性研究。通过美国人口普查数据获得社会经济地位（SES），并使用Yost评分进行比较。使用标准统计方法进行比较。
总共对393名患者进行了评估，325（83％）白色和68（17％）黑色。每个种族的人口统计信息和手术方法相似。然而,与白人相比，黑人患者的最佳减积率较低[89%vs.71%,分别（p=0.001）]和腹膜内化疗（19％vs.11%,p=0.01)。黑人女性的SES参数较低，包括教育程度，收入,和贫困。因此,与白人患者相比，黑人患者的SES-1水平最低(17%vs.41%,p<0.001)。当通过cox回归分析控制这些因素时，在黑人女性中，无进展生存期都存在生存劣势(16vs.27个月,p=0.003）和总生存率（42vs.88个月,p<0.001)。
尽管控制了临床和环境因素，在深南地区的黑人卵巢癌患者中仍然存在生存劣势.黑人妇女的最佳减瘤率较低，铂耐药疾病较多。这些数据表明，肿瘤生物学等其他因素可能在种族生存差异中起作用，然而,需要更多的研究来确定这种因果关系。
对2007年至2014年的卵巢癌患者进行了回顾性研究。通过美国人口普查数据获得社会经济地位（SES），并使用Yost评分进行比较。使用标准统计方法进行比较。
总共对393名患者进行了评估，325（83％）白色和68（17％）黑色。每个种族的人口统计信息和手术方法相似。然而,与白人相比，黑人患者的最佳减积率较低[89%vs.71%,分别（p=0.001）]和腹膜内化疗（19％vs.11%,p=0.01)。黑人女性的SES参数较低，包括教育程度，收入,和贫困。因此,与白人患者相比，黑人患者的SES-1水平最低(17%vs.41%,p<0.001)。当通过cox回归分析控制这些因素时，在黑人女性中，无进展生存期都存在生存劣势(16vs.27个月,p=0.003）和总生存率（42vs.88个月,p<0.001)。
尽管控制了临床和环境因素，在深南地区的黑人卵巢癌患者中仍然存在生存劣势.黑人妇女的最佳减瘤率较低，铂耐药疾病较多。这些数据表明，肿瘤生物学等其他因素可能在种族生存差异中起作用，然而,需要更多的研究来确定这种因果关系。
