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

Table 3 Cox proportional hazard model of time-to-death among ovarian cancer patients

Predictor	Model 11		Model 21
	Hazard ratio (95%CI)	P value	Hazard ratio (95%CI)	P value
Received surgery SOC2
Yes	1.00		1.00
No	1.22 (1.12-1.33)	< 0.01	1.21 (1.11-1.31)	< 0.01
Received chemotherapy SOC2			4
Yes	1.00		4
No, but received some chemotherapy	0.95 (0.89-1.02)	0.18	4
Received no chemotherapy	1.29 (1.14-1.46)	< 0.01	4
Age at diagnosis
66-69	1.00		1.00
70-74	1.07 (0.98-1.17)	0.13	1.05 (0.97-1.15)	0.24
75-79	1.23 (1.12-1.34)	< 0.01	1.21 (1.10-1.32)	< 0.01
80-84	1.52 (1.37-1.69)	< 0.01	1.48 (1.33-1.65)	< 0.01
≥ 85	1.96 (1.70-2.26)	< 0.01	1.92 (1.67-2.21)	< 0.01
Race
White	1.00		1.00
African American	1.11 (0.95-1.29)	0.18	1.13 (0.97-1.32)	0.12
Other	0.90 (0.78-1.05)	0.17	0.88 (0.75-1.02)	0.09
Year of diagnosis
1993-1997	1.27 (1.17-1.38)	< 0.01	1.24 (1.14-1.35)	< 0.01
1998-2002	1.18 (1.09-1.27)	< 0.01	1.17 (1.08-1.27)	< 0.01
2003-2006	1.00		1.00
Treatment stage
IA/IB	0.20 (0.18-0.23)	< 0.01	0.17 (0.15-0.20)	< 0.01
IC/II	0.35 (0.32-0.40)	< 0.01	0.36 (0.32-0.40)	< 0.01
IIIA/IIIB	0.61 (0.53-0.71)	< 0.01	0.62 (0.54-0.71)	< 0.01
IIIC/IV	1.00		1.00
Charlson-Klabunde comorbidity score
0	1.00		1.00
1	1.28 (1.18-1.38)	< 0.01	1.26 (1.17-1.36)	< 0.01
2	1.38 (1.22-1.56)	< 0.01	1.37 (1.21-1.55)	< 0.01
3	1.64 (1.34-2.00)	< 0.01	1.64 (1.34-2.01)	< 0.01
≥ 4	2.33 (1.73-3.15)	< 0.01	2.27 (1.67-3.09)	< 0.01
Histology
Serous	1.00		1.00
Endometrioid	0.76 (0.68-0.85)	< 0.01	0.75 (0.68-0.84)	< 0.01
Mucinous	1.22 (1.06-1.41)	< 0.01	1.22 (1.06-1.41)	< 0.01
Clear cell	0.83 (0.69-1.00)	0.05	0.83 (0.69-1.00)	0.05
Transitional	0.79 (0.47-1.31)	0.36	0.79 (0.48-1.32)	0.37
Adenocarcinoma (NOS)	1.07 (0.98-1.18)	0.14	1.07 (0.97-1.17)	0.2
Other	1.02 (0.82-1.28)	0.85	1.02 (0.82-1.28)	0.85
Marital status
Married	1.00		1.00
Not Married	1.07 (1.00-1.14)	0.05	1.07 (1.00-1.14)	0.05
Unknown	1.00 (0.82-1.23)	0.97	0.99 (0.80-1.21)	0.89
Surgeon specialty3
Non-GO	1.00		1.00
GO	0.90 (0.84-0.96)	< 0.01	0.90 (0.84-0.97)	< 0.01
Chemotherapy specialty3
Non-GO	4		1.00
GO	4		0.98 (0.89-1.08)	0.68
Did not receive chemotherapy	4		1.33 (1.19-1.47)	< 0.01

¹Model 1 and Model 2: Includes OC patients who did not have an unknown FIGO stage at diagnosis, and survived at least 4.5 mo after diagnosis;

²Minimum SOC procedure codes for surgery;

³Missing surgeon and physician specialty excluded from analysis;

⁴Excluded from the model based inclusion criteria. Chemotherapy SOC and chemotherapy physician specialty cannot be included in the same model because the common level of “did not receive chemotherapy” would introduce a singularity and prevent model convergence. OC: Ovarian cancer; SOC: Standard of care; GO: Gynecologic oncologist; FIGO: International Federation of Gynecologists and Obstetricians; NOS: Not otherwise specified.