A comprehensive analysis of ovarian cancer treatment outcomes has revealed that remission rates remained stable despite significant healthcare disruptions during the COVID-19 pandemic. The study, published in Cancer Management and Research, examined data from Kaiser Permanente Southern California's diverse patient population.
Treatment Outcomes Remain Consistent
The research evaluated 748 patients diagnosed with epithelial ovarian cancer between January 2017 and June 2021, with 72.7% diagnosed pre-pandemic and 27.3% during the pandemic. Following initial therapy, 87.2% of patients achieved clinical remission, while 75.1% reached complete remission. The comparison showed nearly identical complete remission rates of 75.7% pre-pandemic versus 73.5% during the pandemic (P = .53).
Patient Demographics and Disease Characteristics
The study population represented diverse demographics, with 46.8% non-Hispanic White, 33.0% Hispanic, 12.4% Asian/Pacific Islander/other races, and 7.5% non-Hispanic Black patients. Disease staging at diagnosis followed typical patterns, with FIGO stage III being most common (39.6%), followed by stage I (27.8%), stage IV (21.5%), and stage II (11.1%).
Pandemic Impact and Treatment Adaptations
During the pandemic, healthcare providers implemented significant modifications to cancer care protocols. These changes included:
- Categorization of ovarian cancer interval cytoreductive surgery as "semi-urgent"
- Increased use of neoadjuvant chemotherapy
- Modified treatment recommendations to minimize COVID-19 exposure
- Adaptations to reduce surgery-related complications and hospitalizations
Racial and Ethnic Considerations
A notable finding emerged regarding racial disparities in treatment outcomes. After adjusting for various factors, non-Hispanic White patients demonstrated a 13% higher likelihood of achieving complete remission during the pandemic compared to pre-pandemic periods (RR, 1.13; 95% CI, 1.00-1.28). However, the association between pandemic periods and clinical remission showed no significant variation across racial/ethnic groups (P = .90).
Statistical Analysis and Methodology
The research employed modified Poisson regression to evaluate remission associations with the pandemic period. The analysis revealed:
- No significant correlation between pandemic period and complete remission in bivariate (RR, 0.97; 95% CI, 0.88-1.07) or multivariate models (adjusted RR, 0.98; 95% CI, 0.90-1.06)
- Similar findings for clinical remission in both bivariate (RR, 0.98; 95% CI, 0.92-1.04) and multivariate analyses (adjusted RR, 0.98; 95% CI, 0.92-1.04)
Healthcare System Implications
The study's findings provide reassurance about the resilience of integrated healthcare systems during crisis periods. However, researchers noted that results might not be generalizable to uninsured populations or different healthcare systems, as the study focused on insured patients within an integrated care network.
