Does equal treatment yield equal outcomes? The impact of race on survival in epithelial ovarian cancer

Objective: To determine if race impacts the survival of patients with epithelial ovarian cancer in a large academic medical center. Methods: Demographic and clinical-pathologic information from patients treated at the University of Chicago from 1992-2007 were analyzed. Continuous variables were analyzed with t tests and categorical variables with chi square tests. Survival curves were evaluated using Kaplan-Meier methods and Cox proportional hazard models were constructed for both overall and disease free survival. Results: 209 women with epithelial ovarian cancer were included in the study, 163 (78%) white and 46 (22%) African American. The baseline demographic characteristics and clinico-pathologic factors such as disease stage, grading, CA-125 levels, rates of optimal debulking (< 1 cm residual tumor), platinum sensitivity and American Society of Anesthesiologists score (ASA) were similar between the groups. The median overall survival for African American women was similar: 37.2 months (95% Confidence Interval (CI): 22.5, 52.9) while it was 34.1 months (95% CI: 27.4, 42.6) for white women. Conclusions: There is no evidence of a racial disparity in either treatment or survival for ovarian cancer patients treated at a large academic center. Given that large epidemiologic studies suggested a difference in survival between African American and white women, other sources of disparities must be sought.