Abstract:
BACKGROUND:Timely hospice referral is an essential component of quality end-of-life care, although a growing body of research suggests that for patients with various types of cancer, hospice referrals often occur very late in the course of care, and are marked by sociodemographic disparities. However, little is known about the ovarian cancer patient population specifically. We examined the extent and timing of hospice referrals in ovarian cancer patients over age 65, and the factors associated with these outcomes. METHODS:We used the Surveillance, Epidemiology, and End Results (SEER)-Medicare database to identify 8211 women aged 66+ with ovarian cancer who were diagnosed between 2001 and 2005 and died by December 31, 2007. We excluded women who were not eligible for Medicare A continuously during the 6 months prior to death. Outcomes studied included overall hospice use in the last 6 months of life and late hospice enrollment, defined as within 3 days of death. We examined variations in these two measures based on year of diagnosis and sociodemographic characteristics (age, race, marital status, rural residence, income, education) and type of Medicare received (fee-for-service vs. managed care). RESULTS:Among 8211 women in the cohort who died from ovarian cancer, 39.7% never received hospice care (3257/8211). Overall hospice care increased over the period of observation, from 49.7% in 2001 to 63.6% [corrected] in 2005, but the proportion of women receiving hospice care within 3 days of death did not improve. Among those who received hospice care, 11.2% (556/4954) and 26.2% (1299/4954) received such care within 3 and 7 days of death, respectively. A higher proportion of black women (46.5% vs. 38.4% among whites), women in the lowest income group (42.8% vs. 37.0% in the highest income group), and those receiving fee-for-service Medicare (41.3% vs.33.5% for women in managed care) never received hospice care. In multivariable models, factors associated with lack of hospice care included age younger than 80 years (OR 1.27, 95% CI 1.15-1.40), non-white race (OR 1.44, 95% CI 1.26-1.65), low income (OR 1.17, 95% CI 1.04-1.32) and enrollment in fee-for-service Medicare compared with managed care (OR 1.39, 95% CI 1.24-1.56). CONCLUSION:More older women with ovarian cancer are receiving hospice care over time, however, a substantial proportion receive such care very near death, and sociodemographic disparities in hospice care exist. Our data also support the need to target lower-income and minority women in efforts to increase optimally timed hospice referrals in this population. Our finding that ovarian cancer patients enrolled in managed care plans were more likely to receive hospice care suggests the importance of health care system factors in the utilization of hospice services.
journal_name
Gynecol Oncoljournal_title
Gynecologic oncologyauthors
Fairfield KM,Murray KM,Wierman HR,Han PK,Hallen S,Miesfeldt S,Trimble EL,Warren JL,Earle CCdoi
10.1016/j.ygyno.2011.11.041subject
Has Abstractpub_date
2012-04-01 00:00:00pages
14-8issue
1eissn
0090-8258issn
1095-6859pii
S0090-8258(11)00959-0journal_volume
125pub_type
杂志文章abstract:BACKGROUND:A case of primary neuroblastoma arising from the broad ligament with excellent response to neoadjuvant bleomycin, etoposide, and cisplatin (BEP) is reported. CASE:A 48-year-old woman, G0, who presented with acute renal failure, an enlarged pelvic mass, and abdominal pain was diagnosed with adult neuroblasto...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2007.06.027
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:All non-invasive diagnostic algorithms suffer from diagnostic uncertainty in discriminating benign from malignant adnexal masses. CASE:We present a case where the identification of a large solitary multiloculated pelvic cyst in a woman with postmenopausal bleeding was shown to be multifocal multicystic beni...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2003.09.036
更新日期:2004-01-01 00:00:00
abstract::From 1973 to 1982 single-dose (0.04 mg/kg or 1.25 mg/m2), biweekly actinomycin D was used to treat 28 women with postmolar, good-prognosis trophoblastic disease. Among the 17 patients fully evaluable for response to treatment 12 were nonmetastatic (NMTD) and 5 had lung metastases (MTD). Nine NMTD patients and 5 MTD pa...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(84)90157-4
更新日期:1984-09-01 00:00:00
abstract:PURPOSE:A constituent of green tea, (-)-epigallocatechin-3-gallate (EGCG), has been known to possess anti-cancer properties. In this study, we investigated the time-course anticancer effects of EGCG on human ovarian cancer cells to provide insights into the molecular-level understanding of growth suppression mechanism ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2004.05.031
更新日期:2004-09-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine the cost-effectiveness of selective lymphadenectomy using a preoperative prediction model compared to routine lymphadenectomy for patients undergoing surgery for endometrial cancer in the US and Korea. METHODS:We used a modified Markov model to estimate clinical and eco...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2014.09.020
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Most borderline ovarian tumors (BOTs) are cured with surgery. However BOTs with invasive implants have a poor prognosis with a mortality of 20-40%. The benefit of adjuvant chemotherapy (CT) in this setting remains poorly defined. METHODS:Retrospective study of serous BOT+invasive implants treated with adjuv...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2013.11.006
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVES:To examine the impact of treatment- and disease-related factors on the quality of life of patients with ovarian cancers undergoing chemotherapy. PATIENTS AND METHODS:Over 18 months period, all patients with ovarian cancer receiving chemotherapy at the Saskatoon Cancer Center were recruited. The Functional A...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2003.11.034
更新日期:2004-03-01 00:00:00
abstract::During the time interval 1950 through 1980, 48 patients having a mean age of 60.2 years were treated primarily for melanoma of the vulva. In all but one patient, a surgical therapeutic approach was selected, including 40 modified Basset procedures and 23 pelvic lymphadenectomies. The 5-year survival rate of the eligib...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(83)90090-2
更新日期:1983-10-01 00:00:00
abstract::Clear-cell hidradenocarcinoma is a malignant tumor of sweat gland origin. It is most often found on the trunk, head, and extremities. This case report describes a rare occurrence of this tumor on the vulva of a young woman. The discovery of metastatic disease reflects the potentially aggressive nature of this tumor. ...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1006/gyno.1993.1045
更新日期:1993-02-01 00:00:00
abstract:OBJECTIVES:Abnormalities in the control of cell proliferation and apoptosis have been suggested to contribute to the development and progression of neoplasia. There are at least two pathways that activate apoptosis. The first is a mitochondria-dependent route governed by bcl-2 family proteins. The second is a parallel ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/s0090-8258(03)00411-6
更新日期:2003-11-01 00:00:00
abstract:OBJECTIVE:Overexpression of the tyrosine kinase receptor erbB-2 is important in the pathogenesis of a variety of neoplasms including ovarian cancer. As a strategy to selectively eradicate erbB-2-overexpressing tumor cells, an anti-erbB-2 single-chain immunoglobin (sFv) gene was constructed to direct expression of intra...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1995.1260
更新日期:1995-10-01 00:00:00
abstract::In situ hybridization (ISH) and polymerase chain reaction (PCR) for several common HPV types were performed on 41 cases of vulvar dystrophy, 19 of which were associated with previous or simultaneous invasive squamous cell carcinoma of the vulva. Three of the 19 cases (16%) of dystrophy associated with cancer were foun...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1996.0151
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVE:Voiding dysfunctions represent a leading morbidity after radical hysterectomy performed in patients with early-stage cervical cancer. The aim of this study was to perform ad hoc analysis of factors influencing voiding recovery in SENTIX (SENTinel lymph node biopsy in cervIX cancer) trial. METHODS:The SENTIX ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2020.12.018
更新日期:2021-01-05 00:00:00
abstract:OBJECTIVE:Inguinal metastasis is a rare manifestation of ovarian cancer. Autopsy studies have reported inguinal metastasis in 0-3% of patients with advanced disease. CASE REPORT:We describe a 43-year-old patient with ovarian cancer limited to the adnexa who had an isolated metastasis in an enlarged inguinal lymph node...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1999.5592
更新日期:1999-12-01 00:00:00
abstract::C-reactive protein (CRP) is an acute phase reactant that appears to have a variety of biologic effects, including stimulation of prostaglandin production by peripheral blood monocytes. Both CRP and 6-keto prostaglandin F 1-alpha (6-keto PGF1-alpha) have been noted to be elevated in the sera of patients with malignant ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(90)90175-k
更新日期:1990-02-01 00:00:00
abstract:OBJECTIVE:Collagen gel constitutes a valuable tool for the study of cell-matrix interactions; however, it is sometimes difficult to use the gel, in which tumor and stromal cells are cocultured, for immunohistochemistry, because it is easily broken during the process of fixation and embedding in paraffin, especially aft...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/s0090-8258(03)00335-4
更新日期:2003-08-01 00:00:00
abstract:OBJECTIVES:To investigate access to surgical care for endometrial cancer in Arizona. METHODS:The Arizona HealthQuery (AZHQ) data warehouse with claims information on over 7 million patients in Arizona was searched using the International Classification of Disease (ICD-9) codes and Current Procedural Terminology (CPT) ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2010.11.028
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVE:This study investigated the relationship between 13 proteins involved in DNA damage and the outcomes of patients with recurrent ovarian cancer (ROC). PATIENTS AND METHODS:Immunohistochemistry staining was performed in 114 diagnostic samples from patients with serous ROC who participated in the OVA-301 study,...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2013.10.032
更新日期:2014-01-01 00:00:00
abstract::To determine the morbidity associated with delivery of intraperitoneal chemotherapy via subcutaneous semipermanent infusion catheters, we analyzed the data on 227 patients treated from April 1985 through December 1989. A total of 249 catheters were inserted and used to administer chemotherapy in these patients. There ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(91)90266-8
更新日期:1991-05-01 00:00:00
abstract::A model system of exfoliated normal human cervicovaginal squamous cells, exfoliated rodent tumor cells, and acellular, viscous, mucuslike material was used to investigate cell deposition on smear preparations made with three different instruments: plastic spatulas, wooden spatulas, and brush-tipped collectors. The tot...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(90)90426-l
更新日期:1990-11-01 00:00:00
abstract:OBJECTIVE:The aim of this study is to evaluate the efficacy of intraperitoneal cisplatin as consolidation treatment in epithelian ovarian cancer patients with complete pathologic response following front-line platin-based chemotherapy. PATIENTS AND METHODS:Thirty patients who had no evidence of disease as assessed by ...
journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章
doi:10.1016/j.ygyno.2003.10.002
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVES:Women with advanced-stage, low-grade serous ovarian carcinoma (LGSC) have low chemotherapy response rates and poor overall survival. Most LGSC tumors overexpress hormone receptors, which represent a potential treatment target. Our study objective was to determine the outcomes of patients with advanced-stage ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2017.07.127
更新日期:2017-10-01 00:00:00
abstract::From November 1983 to October 1992, 22 patients with invasive cervical cancer stage IB through stage IIIB with metastasis to para-aortic nodes were entered in this study. Five patients were excluded. Of 17 remaining evaluable patients, 5 (29%) were stage IB, 6 (35%) were stage IIB, and 6 (35%) were stage IIIB. Four (2...
journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1006/gyno.1994.1057
更新日期:1994-03-01 00:00:00
abstract:OBJECTIVES:To assess sexual function of vulvar cancer survivors who received extensive and less extensive treatment. To explore associations between sexual function and patient, disease, treatment, and psychological variables. METHODS:Sexual function (Female Sexual Function Index, FSFI), mental and physical well-being...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2012.04.015
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the sensitivity of sentinel node (SN) ultrastaging and to define parameters that may reduce the overall false-negative rate in women with early-stage cervical cancer. METHODS:We analyzed data from a large retrospective multicenter cohort group with FIGO stages IA-IIB cervical cancer in whom at le...
journal_title:Gynecologic oncology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ygyno.2012.08.035
更新日期:2012-12-01 00:00:00
abstract::From June 1, 1984, to May 31, 1985, 98 cases of epithelial ovarian carcinomas were assessed and followed prospectively using a new murine monoclonal antibody OC 125 which detects the antigen CA 125. Serous tumors comprised 43.7% of cases, mucinous tumors 20.4%, endometrioid tumors 16%, and other epithelial tumors 19.4...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(88)90042-x
更新日期:1988-05-01 00:00:00
abstract::Elective oophorectomy at the time of hysterectomy for benign disease in women during their fifth decade is an important issue for both gynecologist and patient. It has been suggested that cancer developing in the residual ovary has a worse prognosis than the national average (L. McGowan, Obstet. Gynecol. 69, 386, 1987...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(91)90065-d
更新日期:1991-11-01 00:00:00
abstract::The c-erbB-2 mRNA was detected by the S1 nuclease protection assay and Northern blotting in breast cancer tissues. In contrast to the Northern blot analysis which has been used in all recent publications concerning c-erbB-2 expression on the level of RNA, the S1-nuclease protection assay has distinct advantages with r...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(92)90111-u
更新日期:1992-11-01 00:00:00
abstract:OBJECTIVE:To analyze local recurrence rate (LRR), morbidities and oncologic outcome of class III nerve-sparing radical hysterectomy. PATIENTS AND METHODS:170 consecutive class III NSRH cases were performed. Nineteen patients were addressed directly to surgery whilst neoadjuvant chemotherapy was administered in 151 pat...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2010.07.030
更新日期:2010-11-01 00:00:00
abstract::Five cases of primary vaginal melanoma were treated at UCLA Medical Center between 1976 and 1986. Two additional cases of melanoma arising at the junction of the vulva and vagina are presented. One of seven (13%) patients is alive, with a median time to recurrence of 7 months, and median survival of 31 months. Four of...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1016/0090-8258(89)90603-3
更新日期:1989-04-01 00:00:00