TABLE 2.
Multivariable logistic regression predictors of adherence to CoC Quality Measure 2a (surgical resection within 120 days of neoadjuvant chemotherapy) and influence on all-cause mortality as predicted by Cox proportional hazards modeling
| Surgery within 120 days of neoadjuvant chemotherapy n = 32,098 |
|||||
|---|---|---|---|---|---|
| Mean sample percentage | Failure percentage | Failure proportion P value | Odds ratio for failure (95% CI) | Hazard ratio for failure (95% CI) | |
| Sex | .35 | ||||
| Male | 52.22 | 3.62 | 1.02 (0.90–1.16) | 1.16 (1.11–1.20) | |
| Female | 47.78 | 3.42 | Reference | Reference | |
| Age, y | .004 | ||||
| <40 | 0.62 | 2.64 | 0.74 (0.34–1.57) | 0.83 (0.68–1.02) | |
| 40–49 | 6.54 | 3.10 | 0.95 (0.73–1.24) | 0.90 (0.83–0.98) | |
| 50–59 | 21.31 | 3.17 | Reference | Reference | |
| 60–69 | 37.14 | 3.42 | 1.16 (0.99–1.36) | 1.15 (1.09–1.21) | |
| 70–79 | 29.89 | 3.94 | 1.40(1.19–1.67) | 1.44 (1.37–1.52) | |
| ≥80 | 4.51 | 5.14 | 1.98 (1.43–2.74) | 1.83 (1.63–2.05) | |
| Race and ethnicity | .02 | ||||
| Non-Hispanic white | 84.70 | 3.47 | Reference | Reference | |
| Non-Hispanic black | 10.88 | 4.29 | 1.16 (0.93–1.44) | 1.03 (0.96–1.10) | |
| Hispanic | 1.68 | 2.71 | 0.70 (0.44–1.11) | 0.94 (0.81–1.10) | |
| Asian | 2.30 | 4.39 | 1.25 (0.84–1.84) | 0.89 (0.77–1.02) | |
| Other/unknown | 0.44 | 1.55 | 0.44 (0.18–1.07) | 1.01 (0.82–1.24) | |
| Zip Code income quartile | .45 | ||||
| Lowest quartile | 14.50 | 4.02 | 1.07 (0.81–1.43) | 1.08 (0.99–1.18) | |
| Second quartile | 18.13 | 3.47 | 0.94 (0.74–1.18) | 1.05 (0.98–1.13) | |
| Third quartile | 26.26 | 3,36 | 0.90 (0.75–1.08) | 1.04 (0.99–1.10) | |
| Fourth quartile | 35.90 | 3.49 | Reference | Reference | |
| Other/unknown | 5.22 | 3.55 | 1.01 (0.77–1.34) | 1.04 (0.90–1.20) | |
| Zip Code education quartile | .10 | ||||
| Lowest quartile | 16.18 | 3.77 | 1.23 (0.95–1.58) | 1.07 (0.98–1.18) | |
| Second quartile | 24.14 | 3.65 | 1.27 (1.04–1.55) | 1.05 (0.98–1.12) | |
| Third quartile | 25.82 | 3.79 | 1.32 (1.10–1.58) | 1.02 (0.97–1.08) | |
| Fourth quartile | 28.65 | 3.12 | Reference | Reference | |
| Other/unknown | 5.22 | 3.55 | 0.00 (0.00–0.00) | 1.12 (0.62–3.40) | |
| Insurance status | .02 | ||||
| Medicaid or uninsured | 91.42 | 3.46 | 1.42 (1.12–1.79) | 1.07 (0.99–1.16) | |
| Other insurance | 8.58 | 4.38 | Reference | Reference | |
| Clinical stage | .04 | ||||
| 0 | 0.00 | 0.00 | Omitted† | 1.89 (0.71–5.08) | |
| I | 0.80 | 4.19 | Reference | Reference | |
| II | 47.04 | 3.82 | 0.83 (0.42–1.65) | 0.78 (0.57–1.07) | |
| III | 49.25 | 3.24 | 0.66 (0.33–1.30) | 1.15 (0.84–1.56) | |
| IV | 1.33 | 3.68 | 0.85 (0.36–1.98) | 1.77 (1.17–2.67) | |
| Other/unknown | 1.59 | 5.34 | 1.23 (0.54–2.80) | 0.98 (0.69–1.40) | |
| Tumor size, cm | .23 | ||||
| ≤1 | 2.48 | 4.10 | Reference | Reference | |
| 2 | 2.57 | 3.53 | 0.96 (0.65–1.42) | 1.04 (0.91–1.18) | |
| 3 | 18.14 | 3.48 | 0.85 (0.58–1.25) | 1.06 (0.94–1.21) | |
| 5 | 21.68 | 3.18 | 0.92 (0.63–1.35) | 1.18 (1.03–1.35) | |
| 7 | 31.50 | 3.48 | 1.01 (0.60–1.51) | 1.23 (1.05–1.37) | |
| >8 | 13.89 | 3.77 | 1.17 (0.77–1.79) | 1.59 (1.38–1.85) | |
| Other/unknown | 9.73 | 4.24 | 1.00 (0.57–1.73) | 1.34 (1.11–1.61) | |
| Type of hospital | .07 | ||||
| Large urban region | 49.78 | 3.83 | Reference | Reference | |
| Medium urban region | 17.77 | 3.24 | 0.84 (0.71–1.00) | 1.04 (0.99–1.10) | |
| Small urban region | 25.38 | 3.35 | 0.86 (0.72–1.01) | 1.03 (0.98–1.09) | |
| Rural region | 1.59 | 2.49 | 0.61 (0.37–1.00) | 1.02 (0.89–1.16) | |
| Other/unknown | 5.48 | 3.29 | 0.76 (0.52–1.11) | 1.00 (0.88–1.15 ) | |
| Type of hospital | .06 | ||||
| Community | 64.63 | 3.39 | Reference | Reference | |
| Academic | 35.37 | 3.81 | 1.12 (0.97–1.30) | 0.88 (0.83–0.92) | |
| Patient travel distance, miles | .44 | ||||
| >5 | 29.89 | 3.65 | 1.01 (0.88–1.16) | 0.97 (0.93–1.01) | |
| <5 | 70.11 | 3.47 | Reference | Reference | |
| Time period* | <.001 | ||||
| 1998–2000 | 14.41 | 4.57 | Reference | Reference | |
| 2001–2003 | 18.39 | 4.95 | 1.09 (0.87–1.35) | 1.00 (0.94–1.05 ) | |
| 2004–2006 | 24.49 | 3.27 | 0.66 (0.54–0.81) | 0.81 (0.77–0.85) | |
| 2007–2009 | 24.93 | 3.01 | 0.60 (0.49–0.75 ) | Omitted* | |
| 2010–2011 | 17.77 | 3.10 | 0.62 (0.50–0.79) | Omitted* | |
| Surgery within 120 days of neoadjuvant chemotherapy | 1.17 (1.07–1.27) | ||||
CI, Confidence interval.
*
NCDB survival data only available for patients diagnosed from 1998 to 2006. Survival analysis n = 16,237.
†
Stage 0 predicted failure perfectly,7 observations deleted.