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Scholarly Works (2 results)

  • Thesis
  • Peer Reviewed
UC Irvine Electronic Theses and Dissertations (2017)

ABSTRACT OF THE THESIS

Impact of Race and Ethnicity on Short-term Surgical Outcomes in Women Treated

for Cervical Cancer: American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), 2011-2014

By

Paula M. Gutierrez

Master of Science in Biomedical and Translational Science

University of California, Irvine, 2017

Professor Dr. Robert E. Bristow, Chair

Variations in access to U.S. healthcare have contributed to racial and ethnic disparities in cervical cancer survival and mortality patterns. Evaluation of postoperative complications after cervical cancer surgery in American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) hospitals’ remains limited. In this study, we investigate the association between race/ethnicity and 30-day morbidity in women undergoing cervical cancer surgery.

Using ACS-NSQIP database, 1248 patients undergoing surgery in 2011-2014 were identified. In this cohort, 70.6% were non-Hispanic White, 12.8% Black and 16.5% Hispanic. Compared to non-Hispanic White, these minority groups were more likely to have medical comorbidities. In adjusted multivariable models, the odds of any postoperative complication were 50% greater in Black compared to non-Hispanic White (p<0.05), including non-surgical complications (OR=1.55, p<0.05). Hispanic ethnicity was not a predictor of 30-day morbidity (OR=0.76; p>0.05).

While Black patients experienced greater non-surgical adverse outcomes, no disparity was observed for Hispanic patients. Findings suggest that to some extent access to ACS NSQIP hospitals can attenuate disparities in postoperative complications after cervical cancer surgery, but much more work is still required to eliminate racial/ethnic disparities.

    Cover page: Impact of Race and Ethnicity on Short-term Surgical Outcomes in Women Treated for Cervical Cancer: American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), 2011-2014
    • Article
    • Peer Reviewed
    UC Irvine Previously Published Works (2016)
    Tumor models in mice offer opportunities for understanding tumor formation and development of therapeutic treatments for hepatocellular carcinoma. In this study, subcutaneous or intra-hepatic Hepa129 tumors were established in C3H mice. Tumor growth was determined by daily measurements of subcutaneous tumors and post-mortem studies of subcutaneous and intrahepatic tumors. Administration of Edu was used to determine cell generation dates of tumor cells. Immunohistochemistry with antibodies directed at CD31 or CD34, and intravenous injection of labeled tomato lectin revealed tumor vasculature. Tissue sections also were processed for immunohistochemistry using a panel of antibodies to proteoglycans. Comparison of Edu labeled cells with immunoreactivity allowed determination of development and differentiation of tumor cells after cell generation. Subcutaneous and intrahepatic tumors displayed similar growth over 3 weeks. Immunohistochemistry showed strong labeling for glypican-3, 9BA12, and chondroitin sulfate of tumors in both loci, while normal liver was negative. Tumor regions containing Edu labeled cells did not show significant immunohistochemical labeling for the tumor markers until 2-3 days after Edu treatment; overlap of Edu labeled cells and immunohistochemically labeled tumor regions appeared to reach a maximum at 5 days after Edu treatment. Ectopic subcutaneous tumors displayed vascular ingrowth as the tumor cells expressed immunocytochemical markers; subcutaneous tumors displayed significantly more vascular elements than did intrahepatic tumors.
      Cover page: Development, differentiation, and vascular components of subcutaneous and intrahepatic Hepa129 tumors in a mouse model of hepatocellular carcinoma.
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