Influence of gynecologic oncologists on the survival of XXXX with @entity1204 .

@entity1204 @entity1 @entity5 @entity66
PURPOSE: Despite a lack of evidence for survival benefit, the American College of Obstetrics and Gynecology has recommendations for referral to gynecologic oncologists for the treatment of @entity1204 . Therefore, we propose to determine the influence of gynecologic oncologists on the treatment and survival of @entity1 with @entity1204 . @entity1 AND METHODS: Data were obtained from Medicare and Surveillance, Epidemiology, and End Results (SEER) databases from 1988 to 2005. Kaplan-Meier and Cox proportional hazard methods were used for analyses. RESULTS: Of 18,338 @entity1 , 21.4% received care from gynecologic oncologists (group A) while 78.6% were treated by others (group B). @entity1 in group A were older (age > 71 years: 49.6% v 44%; P < .001), had more lymph nodes (> 16) removed (22% v 17%; P < .001), presented with more advanced (stages III to IV) @entity5 (21.9% v 14.6%; P < .001), had higher-grade @entity5 (P < .001), and were more likely to receive chemotherapy for advanced disease (22.6% v 12.4%; P < .001). In those with stages II to IV disease, the 5-year @entity66 ( @entity66 ) of group A was 79% versus 73% in group B (P = .001). Moreover, in @entity5 , group A had 5-year @entity66 of 72% versus 64% in group B (P < .001). However, no association with @entity66 was identified in stage I @entity5 . On multivariable analysis, younger age, early stage, lower grade, and treatment by gynecologic oncologists were independent prognostic factors for improved survival. CONCLUSION: @entity1 with @entity1204 treated by gynecologic oncologists were more likely to undergo staging surgery and receive adjuvant chemotherapy for advanced disease. Care provided by gynecologic oncologists improved the survival of those with high-risk @entity5 .
