Table 2. Surgical Mortality and 5-Survival of the Study Group.
| Cervical | Ovarian | Endometrial | |||||||||||||||||||||||||
| Overall | pa | Facility | Hospital Volume | Overall | pa | Facility | Hospital Volume | Overall | pa | Facility | Hospital Volume | ||||||||||||||||
| TF | NTF | pb | HVC | IVC | LVC | pc | TF | NTF | pb | HVC | IVC | LVC | pc | TF | NTF | pb | HVC | IVC | LVC | pc | |||||||
| Surgical Mortality (%) | |||||||||||||||||||||||||||
| 30 day | 1.5 | 0.8 | 1.7 | 0.04 | 0.9 | 1.3 | 2.5 | <0.01 | 6.1 | 4.5 | 6.4 | 0.07 | 5.0 | 5.5 | 7.8 | <0.01 | 3.7 | 2.0 | 3.9 | 0.08 | 2.9 | 3.5 | 5.2 | <0.01 | |||
| 90 day | 3.7 | 2.7 | 4.0 | 2.9 | 3.3 | 5.0 | 11.6 | 10.0 | 11.8 | 9.9 | 10.6 | 14.3 | 7.2 | 6.4 | 7.3 | 6.9 | 6.6 | 8.5 | |||||||||
| 5 year Survival (Proportion Surviving %) | |||||||||||||||||||||||||||
| Overall | 61.7 | 63.9 | 60.9 | 0.00 | 64.0 | 61.3 | 59.5 | <0.01 | 39.5 | 43.9 | 38.8 | <0.01 | 42.2 | 40.4 | 36.2 | <0.01 | 67.3 | 65.4 | 67.5 | 0.24 | 66.0 | 68.9 | 67.1 | <0.01 | |||
| Age Groups | |||||||||||||||||||||||||||
| <40 | 76.0 | <0.01 | 73.5 | 77.1 | 0.02 | 75.6 | 74.3 | 78.6 | 0.09 | 76.6 | <0.01 | 77.4 | 76.3 | 0.91 | 75.9 | 77.6 | 76.5 | 0.98 | 87.7 | <0.01 | 84.9 | 88.6 | 0.43 | 88.6 | 88.8 | 85.5 | 0.57 |
| 41–65 | 63.1 | 62.4 | 63.4 | 0.58 | 61.8 | 62.9 | 65.0 | 0.60 | 47.7 | 45.4 | 48.3 | 0.27 | 46.6 | 49.8 | 47.0 | 0.13 | 79.6 | 74.6 | 80.5 | <0.01 | 77.2 | 81.3 | 81.0 | <0.01 | |||
| >65 | 41.4 | 45.7 | 40.6 | 0.00 | 46.5 | 40.8 | 39.3 | <0.01 | 28.9 | 32.4 | 28.5 | <0.01 | 32.3 | 29.8 | 25.6 | 0.00 | 58.2 | 52.8 | 58.8 | 0.00 | 56.2 | 60.1 | 58.4 | <0.01 | |||
| Race | |||||||||||||||||||||||||||
| Caucasian | 63.2 | <0.01 | 64.6 | 62.7 | 0.03 | 66.1 | 62.4 | 61.2 | <0.01 | 39.7 | <0.01 | 44.7 | 38.9 | <0.01 | 42.2 | 40.7 | 36.5 | <0.01 | 69.0 | <0.01 | 68.6 | 69.0 | 0.57 | 67.7 | 70.5 | 68.9 | <0.01 |
| AA | 54.2 | 61.7 | 49.8 | <0.01 | 56.9 | 55.7 | 47.3 | <0.01 | 33.7 | 36.4 | 32.9 | 0.08 | 39.6 | 33.7 | 29.1 | <0.01 | 46.0 | 46.4 | 45.9 | 0.75 | 47.3 | 45.1 | 45.1 | 0.57 | |||
| Other | 67.5 | 59.3 | 69.9 | 0.41 | 58.2 | 72.2 | 68.6 | 0.53 | 57.1 | 56.3 | 57.3 | 0.93 | 41.7 | 70.0 | 56.4 | 0.33 | 74.7 | 64.3 | 76.1 | 0.23 | 71.1 | 83.3 | 68.6 | 0.42 | |||
| Ethnicity | |||||||||||||||||||||||||||
| Hispanic | 66.4 | <0.01 | 65.3 | 67.2 | 0.33 | 66.8 | 67.9 | 63.1 | 0.18 | 42.2 | 0.07 | 47.0 | 40.6 | 0.01 | 46.9 | 44.1 | 36.3 | <0.01 | 66.5 | 1.00 | 72.8 | 64.7 | <0.01 | 66.4 | 71.4 | 65.2 | 0.16 |
| Non-Hispanic | 60.9 | 63.5 | 60.0 | 0.00 | 63.4 | 60.1 | 59.2 | <0.01 | 39.3 | 43.6 | 38.6 | <0.01 | 41.8 | 40.3 | 36.1 | <0.01 | 67.2 | 64.0 | 67.6 | 0.02 | 65.6 | 68.7 | 67.3 | <0.01 | |||
| Primary Payor | |||||||||||||||||||||||||||
| insured | 71.6 | <0.01 | 70.1 | 72.0 | 0.58 | 71.1 | 71.7 | 72.0 | 0.92 | 47.8 | <0.01 | 53.4 | 46.8 | 0.00 | 51.3 | 47.4 | 44.6 | <0.01 | 77.8 | <0.01 | 79.3 | 77.7 | 0.21 | 75.8 | 83.2 | 75.3 | <0.01 |
| non-insured | 63.1 | 64.6 | 61.9 | 0.60 | 65.1 | 64.7 | 56.2 | 0.10 | 53.5 | 61.6 | 51.0 | 0.09 | 55.2 | 52.8 | 52.5 | 0.98 | 71.0 | 73.2 | 69.7 | 0.55 | 72.8 | 69.2 | 68.6 | 0.54 | |||
| Medicare | 52.0 | 59.7 | 50.7 | 0.10 | 59.8 | 53.5 | 47.1 | 0.08 | 37.8 | 44.6 | 37.0 | 0.01 | 39.5 | 38.8 | 34.6 | <0.01 | 63.1 | 62.6 | 63.1 | 0.85 | 62.1 | 62.1 | 66.8 | 0.28 | |||
| Medicaid | 59.4 | 60.6 | 58.4 | 0.94 | 59.5 | 62.7 | 55.4 | 0.24 | 43.4 | 40.1 | 45.1 | 0.62 | 42.6 | 42.3 | 45.3 | 0.98 | 65.4 | 66.8 | 64.7 | 0.95 | 64.8 | 67.5 | 63.9 | 0.77 | |||
| Medicare/Medicaid NOS | 45.1 | 52.3 | 43.5 | 0.05 | 52.4 | 42.2 | 43.1 | 0.04 | 31.2 | 35.3 | 30.6 | 0.00 | 35.4 | 33.7 | 27.7 | <0.01 | 58.3 | 54.3 | 58.8 | 0.54 | 56.5 | 60.2 | 58.1 | 0.13 | |||
| Government | 74.2 | 100.0 | 61.9 | 0.10 | 80.0 | 62.5 | 100.0 | 0.36 | 70.0 | ND | 77.8 | 0.11 | 84.6 | 50.0 | ND | 0.35 | 72.4 | 81.8 | 66.7 | 0.79 | 62.5 | 80.0 | 100.0 | 0.71 | |||
| LN examined | |||||||||||||||||||||||||||
| none | 55.9 | <0.01 | 55.6 | 56.0 | 0.37 | 51.7 | 56.1 | 58.2 | 0.21 | 31.8 | <0.01 | 37.1 | 31.0 | <0.01 | 34.0 | 30.9 | 31.0 | <0.01 | 65.9 | <0.01 | 63.0 | 66.2 | 0.26 | 63.0 | 68.8 | 65.4 | <0.01 |
| 1 through 10 | 65.8 | 63.6 | 66.6 | 0.24 | 60.9 | 68.4 | 71.6 | 0.05 | 53.7 | 52.8 | 54.0 | 0.87 | 49.6 | 56.5 | 58.7 | 0.21 | 71.0 | 71.2 | 70.9 | 0.82 | 69.8 | 72.1 | 71.8 | 0.55 | |||
| 11 through 20 | 77.4 | 74.6 | 78.8 | 0.19 | 76.9 | 77.9 | 78.2 | 0.78 | 60.7 | 58.5 | 61.3 | 0.57 | 61.3 | 64.1 | 53.0 | 0.46 | 73.5 | 79.0 | 72.2 | 0.05 | 74.0 | 73.2 | 71.6 | 0.65 | |||
| 21–30 | 80.7 | 74.9 | 84.5 | 0.00 | 81.2 | 80.6 | 77.1 | 0.82 | 68.4 | 78.8 | 66.3 | 0.16 | 71.6 | 62.8 | 68.0 | 0.41 | 71.0 | 76.1 | 70.2 | 0.21 | 70.4 | 71.7 | 73.1 | 0.86 | |||
| >30 | 82.0 | 83.1 | 81.0 | 0.82 | 84.9 | 75.5 | 93.4 | 0.05 | 57.4 | 63.0 | 55.8 | 0.31 | 60.0 | 54.5 | 50.0 | 0.62 | 76.6 | 84.9 | 74.7 | 0.06 | 75.7 | 75.2 | 89.5 | 0.49 | |||
| Unknown | 59.5 | 62.1 | 58.6 | 0.01 | 40.6 | 43.8 | 40.1 | 0.00 | 41.8 | 43.0 | 37.5 | <0.01 | 66.3 | 61.1 | 67.0 | <0.01 | 64.1 | 67.7 | 67.3 | <0.01 | |||||||
| Tumor stage | |||||||||||||||||||||||||||
| Localized | 81.0 | <0.01 | 82.7 | 80.4 | 0.04 | 83.0 | 80.4 | 79.3 | 0.02 | 78.6 | <0.01 | 81.3 | 78.1 | 0.10 | 81.6 | 78.3 | 76.2 | 0.01 | 77.9 | <0.01 | 78.8 | 77.8 | 0.12 | 77.8 | 79.1 | 76.4 | <0.01 |
| Regional | 48.6 | 51.2 | 47.4 | 0.02 | 50.5 | 48.8 | 45.2 | <0.01 | 48.9 | 64.0 | 46.9 | <0.01 | 55.3 | 46.4 | 45.0 | <0.01 | 50.3 | 52.9 | 49.8 | 0.07 | 50.7 | 51.3 | 47.8 | 0.06 | |||
| Distant | 19.5 | 24.4 | 17.6 | 0.00 | 23.0 | 17.4 | 17.6 | <0.01 | 25.8 | 31.6 | 24.7 | <0.01 | 27.8 | 28.0 | 22.0 | <0.01 | 20.3 | 19.1 | 20.6 | 0.52 | 17.3 | 23.2 | 22.1 | 0.01 | |||
| Tumor Grade | |||||||||||||||||||||||||||
| Well differentiated | 74.5 | <0.01 | 74.7 | 74.4 | 0.85 | 76.1 | 72.5 | 74.9 | 0.79 | 68.4 | <0.01 | 64.7 | 69.0 | 0.68 | 71.0 | 67.7 | 65.7 | 0.10 | 83.0 | <0.01 | 83.1 | 83.0 | 0.55 | 82.4 | 83.9 | 82.5 | 0.25 |
| Moderately differentiated | 62.6 | 66.3 | 61.3 | 0.02 | 65.6 | 62.0 | 59.8 | 0.02 | 44.7 | 48.5 | 44.0 | 0.08 | 44.8 | 46.7 | 42.7 | 0.10 | 71.5 | 69.0 | 71.8 | 0.26 | 71.8 | 73.2 | 69.2 | 0.01 | |||
| Poorly differentiated | 54.3 | 59.8 | 51.9 | <0.01 | 60.7 | 52.9 | 46.9 | <0.01 | 31.9 | 34.9 | 31.3 | 0.00 | 33.6 | 33.8 | 27.2 | <0.01 | 44.4 | 47.6 | 43.9 | 0.14 | 44.7 | 45.0 | 43.1 | 0.18 | |||
| Undifferentiated | 40.5 | 38.9 | 41.0 | 0.63 | 55.0 | 32.8 | 34.6 | 0.05 | 32.2 | 39.5 | 30.7 | 0.23 | 31.4 | 36.9 | 27.6 | 0.01 | 30.4 | 30.3 | 30.5 | 0.61 | 25.8 | 38.2 | 30.8 | 0.10 | |||
| Surgical Extirpation | |||||||||||||||||||||||||||
| Yes | 75.0 | <0.01 | 76.5 | 74.4 | 0.04 | 76.5 | 75.4 | 72.5 | <0.01 | 45.7 | <0.01 | 47.2 | 45.4 | 0.07 | 46.3 | 46.6 | 44.1 | <0.01 | 70.8 | <0.01 | 68.6 | 71.1 | 0.08 | 69.4 | 72.4 | 70.6 | <0.01 |
| No | 41.7 | 43.2 | 41.2 | 0.03 | 38.5 | 42.9 | 42.9 | 0.03 | 18.9 | 26.3 | 18.2 | <0.01 | 22.8 | 18.0 | 17.4 | <0.01 | 48.0 | 40.2 | 48.8 | 0.13 | 39.3 | 45.2 | 55.4 | <0.01 | |||
| Chemotherapy | |||||||||||||||||||||||||||
| Yes | 40.5 | <0.01 | 41.0 | 40.4 | 0.68 | 43.7 | 38.6 | 37.4 | 0.49 | 37.8 | <0.01 | 42.9 | 36.6 | <0.01 | 40.6 | 38.0 | 32.9 | <0.01 | 30.9 | <0.01 | 33.9 | 30.2 | 0.43 | 31.4 | 29.2 | 32.7 | 0.74 |
| No | 65.0 | 68.3 | 63.9 | <0.01 | 68.5 | 64.7 | 62.0 | <0.01 | 41.1 | 45.5 | 40.6 | <0.01 | 44.6 | 42.8 | 37.9 | <0.01 | 69.3 | 68.2 | 69.5 | 0.68 | 68.6 | 70.9 | 68.4 | <0.01 | |||
| Radiation | |||||||||||||||||||||||||||
| Yes | 47.0 | <0.01 | 50.5 | 45.7 | 0.00 | 47.4 | 48.1 | 44.6 | 0.01 | 40.7 | 0.29 | 43.1 | 40.4 | 0.74 | 43.1 | 41.5 | 35.8 | 0.28 | 60.1 | <0.01 | 61.8 | 59.9 | 0.21 | 59.5 | 61.8 | 57.2 | 0.02 |
| No | 73.4 | 75.1 | 72.9 | 0.04 | 76.4 | 76.5 | 68.0 | <0.01 | 39.4 | 44.0 | 38.6 | <0.01 | 42.1 | 40.2 | 36.1 | <0.01 | 69.5 | 66.5 | 69.9 | 0.04 | 68.3 | 71.6 | 68.7 | <0.01 | |||
TF = teaching facility; NTF = non-teaching facility; HVC = high-volume center; IVC = intermediate volume center; LVC = low volume center; AA = African American; ND = not determined.
pa value = log rank analysis of survival between categorical variables.
pb value = log rank analysis of survival at TF vs NTF.
pc value = log rank analysis of survival at HVC vs. IVC vs. LVC.