Intraperitoneal chemotherapy among women in the Medicare population with epithelial ovarian cancer.
Document Type
Article
Publication Date
9-1-2014
Institution/Department
CORE; Geriatrics; Obstetrics & Gynecology; Oncology
Journal Title
Gynecologic oncology
MeSH Headings
Aged, Antineoplastic Agents, Female, Healthcare Disparities, Humans, Infusions, Intravenous, Infusions, Parenteral, Medicare, Neoplasms, Glandular and Epithelial, Ovarian Neoplasms, United States
Abstract
BACKGROUND: Intraperitoneal combined with intravenous chemotherapy (IV/IP) for primary treatment of epithelial ovarian cancer results in a substantial survival advantage for women who are optimally debulked surgically, compared with standard IV only therapy (IV). Little is known about the use of this therapy in the Medicare population.
METHODS: We used the Surveillance, Epidemiology, and End Results (SEER)-Medicare database to identify 4665 women aged 66 and older with epithelial ovarian cancer diagnosed between 2005-2009, with their Medicare claims. We defined receipt of any IV/IP chemotherapy when there was claims evidence of any receipt of such treatment within 12 months of the date of diagnosis. We used descriptive statistics to examine factors associated with treatment and health services use.
RESULTS: Among 3561 women with Stage III or IV epithelial ovarian cancer who received any chemotherapy, only 124 (3.5%) received IV/IP chemotherapy. The use of IV/IP chemotherapy did not increase over the period of the study. In this cohort, younger women, those with fewer comorbidities, whites, and those living in Census tracts with higher income were more likely to receive IV/IP chemotherapy. Among women who received any IV/IP chemotherapy, we did not find an increase in acute care services (hospitalizations, emergency department visits, or ICU stays).
CONCLUSION: During the period between 2005 and 2009, few women in the Medicare population living within observed SEER areas received IV/IP chemotherapy, and the use of this therapy did not increase. We observed marked racial and sociodemographic differences in access to this therapy.
ISSN
1095-6859
First Page
473
Last Page
477
Recommended Citation
Fairfield, Kathleen M; Murray, Kimberly; LaChance, Jason A; Wierman, Heidi R; Earle, Craig C; Trimble, Edward L; and Warren, Joan L, "Intraperitoneal chemotherapy among women in the Medicare population with epithelial ovarian cancer." (2014). MaineHealth Maine Medical Center. 219.
https://knowledgeconnection.mainehealth.org/mmc/219