Gynecologic oncologists involvement on ovarian cancer standard of care receipt and survival

Table 2 Predictors of receipt of minimum surgical and chemotherapeutic standard of care¹

	Surgical standard of care2		Chemotherapeutic standard of care2
	Odds ratio (95%CI)	P value	Odds ratio (95%CI)	P value
Physician specialty3
Gynecologic oncologist	2.35 (2.03-2.71)	< 0.01	1.25 (1.07-1.47)	0.006
Non-gynecologic oncologist	1.00		1.00
Age at diagnosis
66-69	1.00		1.00
70-74	0.80 (0.67-0.96)	0.017	0.93 (0.78-1.09)	0.393
75-79	0.83 (0.69-1.0)	0.053	0.79 (0.66-0.94)	0.008
80-84	0.58 (0.47-0.71)	< 0.01	0.61 (0.48-75)	< 0.001
≥ 85	0.40 (0.31-0.51)	< 0.01	0.31 (0.21-0.48)	< 0.001
Race4
White	1.00
African American	0.67 (0.50-0.91)	0.01	-
Other	0.83 (0.62-1.10)	0.208	-
Treatment stage5
IA/IB	0.08 (0.07-0.10)	< 0.01	NA	NA
IC/II	0.08 (0.07-0.10)	< 0.01	3.46 (2.86-4.18)	< 0.001
IIIA/IIIB	0.05 (0.04-0.07)	< 0.01	0.83 (0.64-1.09)	0.182
IIIC/IV	1.00		1.00
Charlson-Klabunde comorbidity score
0	1.00		1.00
1	0.84 (0.72-0.98)	0.029	0.84 (0.71-0.99)	0.029
2	0.81 (0.63-1.02)	0.084	0.78 (0.60-1.03)	0.078
3	0.65 (0.44-0.97)	0.039	0.49 (0.31-0.80)	0.005
4 or more	1.09 (0.60-1.97)	0.771	0.63 (0.29-1.37)	0.247
Histology
Serous	1.00		1.00
Endometrioid	1.10 (0.90-1.35)	0.356	0.70 (0.56-0.89)	0.003
Mucinous	0.95 (0.74-1.35)	0.67	0.49 (0.34-0.70)	< 0.001
Clear cell	1.29 (0.93-1.78)	0.13	0.62 (0.41-0.93)	0.026
Transitional	0.70 (0.27-1.79)	0.454	0.76 (0.30-1.97)	0.572
Adenocarcinoma (NOS)	0.44 (0.37-0.54)	< 0.001	1.04 (0.86-1.27)	0.695
Other	1.05 (0.70-1.56)	0.813	0.74 (0.47-1.13)	0.168
Marital status
Married	1.00		1.00
Not married	0.83 (0.72-0.95)	0.007	0.75 (0.66-0.86)	< 0.001
Unknown	1.03 (0.69-1.52)	0.87	0.73 (0.48-1.09)	0.127
Year of diagnosis
1993-1997	0.62 (0.52-0.73)	< 0.01	0.28 (0.23-0.33)	< 0.001
1998-2002	0.79 (0.68-0.92)	0.003	1.09 (0.94-1.26)	0.261
2003-2006	1.00		1.00
SEER region4
Northeast	-		1.00
Midwest	-		0.76 (0.62-0.93)	0.009
South	-		1.09 (0.88-1.37)	0.424
West	-		0.93 (0.78-1.10)	0.391

¹Minimum SOC treatment was based on patients receiving surgery prior to chemotherapy (n = 6714);

²Surgery SOC (n = 4434) and chemotherapy SOC (n = 2595);

³Physician specialty was categorized according to the most specialized care received during the course of the treatment window; there were 39 and 177 cases where physician specialty could not be identified for surgery or chemotherapy procedures, respectively (results for this group not shown);

⁴Race was not entered into the chemotherapy SOC model based on forward selection entry criteria (P≤ 0.10); Region was not entered into the surgery SOC model based on forward selection entry criteria (P≤ 0.10);

⁵Stage I NOS, Stage IA/IB (for chemotherapy SOC) and unknown/unstaged were removed from the analysis since current guidelines recommend early stage patients not receive chemotherapy treatment. NOS: Not otherwise specified; SOC: Standard of care; SEER: Surveillance, Epidemiology, and End Result; NA: Not applicable.