Table 2:
Patient Characteristics and Factors Favoring Surgery
| All Stage IV Patients |
Patients Receiving Surgery |
Factors Favoring Surgery (Multivariable Analysis) |
||||
|---|---|---|---|---|---|---|
| Variable | N = 11694 (%) | N = 5202 (%) | Odds Ratio (95% CI) |
P value | Type 3 P value |
|
| Age at Diagnosis | Median | 61.00 | 60.00 | NS | NS | NS |
| Race | Caucasian | 9461 (80.9) | 4285 (45.29) | 1.14 (1.00–1.30) | 0.052 | 0.150 |
| African American | 1722 (14.7) | 702 (40.77) | 1.14 (0.89–1.47) | 0.305 | ||
| Other | 511 (4.4) | 215 (42.07) | - | - | ||
| Charlson-Deyo Score | 0 | 9455 (80.9) | 4268 (45.14) | NS | NS | NS |
| 1 | 1704 (14.6) | 743 (43.6) | ||||
| 2+ | 535 (4.6) | 191 (35.7) | ||||
| Facility Type | Community Cancer Program/Other | 1516 (13.0) | 766 (50.53) | 1.98 (1.70–2.30) | <.001 | <.001 |
| Comprehensive Community Cancer Program | 5268 (45.0) | 2488 (47.23) | 1.50 (1.34–1.67) | <.001 | ||
| Integrated Network Cancer Program | 1073 (9.2) | 510 (47.53) | 1.45 (1.22–1.72) | <.001 | ||
| Academic/Research Program | 3837 (32.8) | 1438 (37.48) | - | - | ||
| Facility Location | West | 1785 (15.3) | 810 (45.38) | 1.25 (1.07–1.46) | 0.004 | <.001 |
| Midwest | 2976 (25.4) | 1341 (45.06) | 1.17 (1.03–1.34) | 0.017 | ||
| South | 4163 (35.6) | 1984 (47.66) | 1.48 (1.31–1.68) | <.001 | ||
| Northeast | 2770 (23.7) | 1067 (38.52) | - | - | ||
| Primary Payor | Medicare | 4405 (37.7) | 1843 (41.84) | 1.62 (1.34–1.95) | <.001 | <.001 |
| Medicaid/Other Govt | 1189 (10.2) | 477 (40.12) | 1.23 (0.99–1.54) | 0.065 | ||
| Private | 5214 (44.6) | 2603 (49.92) | 1.80 (1.49–2.17) | <.001 | ||
| Not Insured/Unknown | 886 (7.6) | 279 (31.49) | - | - | ||
| Median Income Quartiles (2000) | <$30,000 | 1615 (14.4) | 737 (45.63) | NS | NS | NS |
| $30,000 - $35,999 | 1920 (17.1) | 840 (43.75) | ||||
| $36,000-$45,999 | 3090 (27.5) | 1383 (44.76) | ||||
| $46,000+ | 4592 (40.9) | 2038 (44.38) | ||||
| Diagnosis Year | >=2004, <=2006 | 3513 (30.0) | 1882 (53.57) | 3.83 (3.34–4.40) | <.001 | <.001 |
| >2006, <=2008 | 2380 (20.4) | 1164 (48.91) | 2.56 (2.21–2.96) | <.001 | ||
| >2008, <=2011 | 3460 (29.6) | 1411 (40.78) | 1.55 (1.36–1.76) | <.001 | ||
| >2011, <=2013 | 2341 (20.0) | 745 (31.82) | - | - | ||
| Grade | Well Differentiated | 684 (5.8) | 370 (54.09) | 3.78 (3.07–4.66) | <.001 | <.001 |
| Moderately Differentiated | 3415 (29.2) | 1773 (51.92) | 3.62 (3.15–4.16) | <.001 | ||
| Poorly Differentiated/Undifferentiated | 4448 (38.0) | 2598 (58.41) | 4.84 (4.22–5.55) | <.001 | ||
| Cell Type Not Determined | 3147 (26.9) | 461 (14.65) | - | - | ||
| Analytic T Stage | T1 | 2025 (17.3) | 1094 (54.02) | 7.64 (5.95–9.82) | <.001 | <.001 |
| T2 | 3372 (28.8) | 2129 (63.14) | 6.08 (4.84–7.63) | <.001 | ||
| T3 | 1319 (11.3) | 693 (52.54) | 4.01 (3.13–5.13) | <.001 | ||
| T4 | 2801 (24.0) | 1137 (40.59) | 3.11 (2.52–3.85) | <.001 | ||
| Unknown | 2177 (18.6) | 149 (6.84) | - | - | ||
| Analytic N Stage | No | 2690 (23.0) | 1272 (47.29) | 1.50 (1.30–1.73) | <.001 | <.001 |
| N1 | 3461 (29.6) | 1573 (45.45) | 1.45 (1.27–1.66) | <.001 | ||
| N2 | 956 (8.2) | 717 (75) | 4.77 (3.90–5.82) | <.001 | ||
| N3 | 1368 (11.7) | 865 (63.23) | 3.17 (2.68–3.75) | <.001 | ||
| Unknown | 3219 (27.5) | 775 (24.08) | - | - | ||
| ER | Negative | 2670 (22.8) | 1366 (51.16) | 1.18 (1.02–1.36) | 0.025 | <.001 |
| Positive | 7882 (67.4) | 3611 (45.81) | 1.11 (0.74–1.68) | 0.617 | ||
| Unknown | 1142 (9.8) | 225 (19.7) | - | - | ||
| PR | Negative | 4123 (35.3) | 2006 (48.65) | 0.93 (0.82–1.06) | 0.258 | <.001 |
| Positive | 6233 (53.3) | 2936 (47.1) | 0.55 (0.38–0.81) | 0.002 | ||
| Unknown | 1338 (11.4) | 260 (19.43) | - | - | ||
| Chemotherapy | No | 5182 (44.3) | 1886 (36.4) | NS | NS | NS |
| Yes | 6145 (52.5) | 3159 (51.41) | ||||
| Unknown | 367 (3.1) | 157 (42.78) | ||||
| Hormone Therapy | No | 5775 (49.4) | 2425 (41.99) | NS | NS | NS |
| Yes | 5508 (47.1) | 2593 (47.08) | ||||
| Unknown | 411 (3.5) | 184 (44.77) | ||||
| Systemic Therapy | Yes | 9470 (81.0) | 4509 (47.61) | 1.29 (1.13–1.48) | <.001 | <.001 |
| Unknown | 105 (0.9) | 42 (40) | 1.61 (0.96–2.72) | 0.073 | ||
| No | 2119 (18.1) | 651 (30.72) | - | - | ||
| Radiation Therapy | Yes | 3510 (30.0) | 3076 (38.38) | 2.21 (2.00–2.45) | <.001 | <.001 |
| Unknown | 169 (1.4) | 79 (46.75) | 1.63 (1.09–2.43) | 0.018 | ||
| No | 8015 (68.5) | 2047 (58.32) | - | - | ||
| Tumor Size | >2, <=4 | 2124 (18.2) | 1299 (61.16) | 1.84 (1.49–2.27) | <.001 | <.001 |
| >4, <=6 | 2234 (19.1) | 1259 (56.36) | 1.59 (1.30–1.95) | <.001 | ||
| >6, <=99 | 2173 (18.6) | 1146 (52.74) | 1.72 (1.39–2.12) | <.001 | ||
| Unknown | 2778 (23.8) | 366 (13.17) | 0.47 (0.38–0.58) | <.001 | ||
| >=0, <=2 | 2385 (20.4) | 1132 (47.46) | - | - | ||