Evidence map›Paper›PMID 25644440›Full record

Observational studyAmerican journal of obstetrics and gynecology2015

Spatial analysis of advanced-stage ovarian cancer mortality in California.

Robert E Bristow, Jenny Chang, Argyrios Ziogas, Daniel L Gillen, Lu Bai, Veronica M Vieira

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in American journal of obstetrics and gynecology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Homologous Recombination Deficiency and Survival in Ovarian High-Grade Serous Carcinoma by Self-Reported Race.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025
    Article
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  5. Review
  6. Article
  7. Article
  8. Article
  9. Do Patients Residing in Provincial Areas Transport and Spend More on Cancer Treatment in Korea?International journal of environmental research and public health · 2021
    Article
  10. Article
  11. Review
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  13. Article
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  15. Article
  16. Contribution of Geographic Location to Disparities in Ovarian Cancer Treatment.Journal of the National Comprehensive Cancer Network : JNCCN · 2019
    Article
  17. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Robert E BristowDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of California, Irvine, Medical Center, Orange, CA; Chao Family Comprehensive Cancer Center, University of California, Irvine, Medical Center, Orange, CA. Electronic address: rbristow@uci.edu.
Jenny ChangDepartment of Epidemiology, University of California, Irvine, School of Medicine, Irvine, CA.
Argyrios ZiogasDepartment of Epidemiology, University of California, Irvine, School of Medicine, Irvine, CA.
Daniel L GillenChao Family Comprehensive Cancer Center, University of California, Irvine, Medical Center, Orange, CA; Department of Statistics, University of California, Irvine, School of Medicine, Irvine, CA.
Lu BaiDepartment of Statistics, University of California, Irvine, School of Medicine, Irvine, CA.
Veronica M VieiraDepartment of Statistics, University of California, Irvine, School of Medicine, Irvine, CA; Program in Public Health, University of California, Irvine, School of Medicine, Irvine, CA.

Funding

Univ.of Calif., Irvine Cancer Center Support GrantP30CA062203 · NCI · UNIVERSITY OF CALIFORNIA-IRVINE · PI Christine Hui · 1994 to 2026
$57.9M
Training CoreP42ES007381 · NIEHS · BOSTON UNIVERSITY MEDICAL CAMPUS · PI HAHN, MARK E · 1995 to 2019
$46.1M
NCI NIH HHS P30 CA062203NCI NIH HHS P30CA062203NIEHS NIH HHS 2P42ES007381-18NIEHS NIH HHS P42 ES007381
6 · The paper itself

Abstract

objectiveWe sought to determine the impact of geographic location on advanced-stage ovarian cancer mortality in relation to adherence to National Comprehensive Cancer Network (NCCN) treatment guidelines and hospital case volume. STUDY

designThis was a retrospective observational cohort study of patients diagnosed with stage IIIC/IV epithelial ovarian cancer (Jan. 1, 1996, through Dec. 31, 2006) identified from the California Cancer Registry. Generalized additive models were created to assess the effect of spatial distributions of geographic location, demographic characteristics, disease-related variables, adherence to NCCN guidelines, and hospital case volume, with simultaneous smoothing of geographic location and adjustment for confounding variables.

resultsA total of 11,765 patients were identified. Twelve of the 378 hospitals (3.2%) were high-volume hospitals (HVH) (≥20 cases/y) and cared for 2112 patients (17.9%). For all patients, the median distance to an HVH was 22.7 km/14.1 miles and 80% were located within 79.6 km/49.5 miles of an HVH. Overall, 45.4% of patients were treated according to NCCN guidelines. The global test for location revealed that geographic position within the state was significantly correlated with ovarian cancer mortality after adjusting for other variables (P < .001). Distance to receive care ≥32 km/20 miles was protective against mortality (hazard ratio [HR], 0.86; 95% confidence interval [CI], 0.79-0.93), while distance from an HVH ≥80 km/50 miles was associated with an increased risk of death (HR, 1.13; 95% CI, 1.03-1.23). The effects of geographic predictors were attenuated when nonadherence to NCCN guidelines (HR, 1.25; 95% CI, 1.18-1.32) and care at an HVH (HR, 0.87; 95% CI, 0.81-0.93) were introduced into the model.

conclusionGeographic location is a significant predictor of advanced-stage ovarian cancer mortality and the effect is primarily related to the likelihood of receiving NCCN guideline adherent care and treatment at an HVH.

Indexed as

AdolescentAdultAgedAged, 80 and overCaliforniaCarcinoma, Ovarian EpithelialFemaleHospitals, High-VolumeHospitals, Low-VolumeHumansMiddle AgedNeoplasms, Glandular and EpithelialOvarian NeoplasmsSpatial AnalysisYoung Adultgeographic locationovarian cancer

Identifiers

PMID25644440
PMCPMC4485540

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.