Cervical cancer survival for patients referred to a tertiary care center in Kentucky

Leigh G. Seamon, Rebecca L. Tarrant, Steve T. Fleming, Robin C. Vanderpool, Sarah Pachtman, Iwona Podzielinski, Adam J. Branscum, Jonathan M. Feddock, Marcus E. Randall, Christopher P. Desimone

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Objectives: To identify prognostic factors influencing cervical cancer survival for patients referred to a tertiary care center in Kentucky. Methods: A cohort study was performed to assess predictive survival factors of cervical cancer patients referred to the University of Kentucky from January 2001 to May 2010. Eligibility criteria included those at least 18 years-old, cervical cancer history, and no prior malignancy. Descriptive statistics were compiled and univariable and multivariable Cox proportional hazard analysis were performed. Results: 381 patients met entry criteria. 95% were Caucasian (N = 347) and 66% (N = 243) lived in Appalachian Kentucky. The following covariates showed no evidence of a statistical association with survival: race, body mass index, residence, insurance status, months between last normal cervical cytology and diagnosis, histology, tumor grade, and location of primary radiation treatment. After controlling for identified significant variables, stage of disease was a significant predictor of overall survival, with estimated relative hazards comparing stages II, III, and IV to stage I of 3.09 (95% CI: 1.30, 7.33), 18.11 (95% CI: 7.44, 44.06), and 53.03(95% CI: 18.16, 154.87), respectively. The presence of more than two comorbid risk factors and unemployment was also correlated with overall survival [HR 4.25 (95% CI: 1.00, 18.13); HR 2.64 (95% CI 1.29, 5.42), respectively]. Conclusions: Residence and location of treatment center are not an important factor in cervical cancer survival when a tertiary cancer center can oversee and coordinate care; however, comorbid risk factors influence survival and further exploration of disease comorbidity related to cervical cancer survival is warranted.

Original languageEnglish
Pages (from-to)565-570
Number of pages6
JournalGynecologic Oncology
Volume123
Issue number3
DOIs
StatePublished - Dec 2011

Keywords

  • Appalachia
  • Cervical cancer
  • Disparities
  • Kentucky
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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