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Gynecologic oncologist impact on adjuvant chemotherapy care for stage II-IV ovarian cancer patients
Journal article   Peer reviewed

Gynecologic oncologist impact on adjuvant chemotherapy care for stage II-IV ovarian cancer patients

Kristin S Weeks, Charles F Lynch, Michele West, Ryan Carnahan, Michael O'Rorke, Jacob Oleson, Megan McDonald, Sherri L Stewart, Mary Charlton and Ovarian Cancer Treatment Study
Gynecologic oncology, Vol.164(1), pp.3-11
01/2022
DOI: 10.1016/j.ygyno.2021.11.001
PMID: 34776243
url
https://www.ncbi.nlm.nih.gov/pmc/articles/11089835View
Open Access

Abstract

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. 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. 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. 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. •Gynecologic oncologist surgeons were associated with increased odds of initiating adjuvant chemotherapy.•Gynecologic oncologist surgeons were associated with greater odds of a gynecologic oncologist chemotherapy provider.•Gynecologic oncologist adjuvant chemotherapy providers were associated with decreased time from surgery-to-chemotherapy.•Rural and urban women traveled farther to receive chemotherapy care with gynecologic oncologist.•Rural women (versus urban) had a gynecologic oncologist involved in their adjuvant chemotherapy less and traveled farther.
 Adjuvant chemotherapy care Gynecologic oncologist Ovarian cancer Rural

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