OBJECTIVES: The purpose of the present study was to determine whether racial disparity exists between African American (AA) and non-African American (NAA) patients with uterine endometrioid carcinoma who received similar multidisciplinary management. METHODS: We identified 766 patients with endometrioid adenocarcinoma 2009 FIGO stages I-II who underwent hysterectomy. Patients were divided into two groups; AA and NAA. Recurrence-free survival (RFS), disease specific survival (DSS) and overall survival (OS) for two groups were calculated. RESULTS: Median follow-up was 5.1 years. 27% were AA and 73% were NAA. All patients underwent hysterectomy and oophorectomy. 80% had peritoneal cytology examination and 69% underwent lymphadenectomy. AA patients were more likely to have higher grade tumors, and higher incidence of lymphovascular space involvement (LVSI). Although the two groups were balanced with regards to surgical staging and adjuvant treatment received, the 5-year RFS and DSS were significantly lower in AA compared to NAA patients (91% vs 84%, p=0.030; 95% vs 88%, p=0.011, respectively). Overall survival was not significantly different between the two groups. On multivariate analysis, after adjusting for other prognostic factors, race (AA vs NAA) was not a significant predictor of outcome. Grade 3 tumors and the presence of LVSI were the only two independent predictors of RFS and DSS with p ≤ 0.001 and p ≤ 0.001, respectively. CONCLUSION: In this large hospital-based study, AA race was associated with a higher incidence of adverse pathological features and worse recurrence-free and disease-specific survival. However, on multivariate analysis race was not an independent prognostic factor. Further studies are needed to elucidate possible underlying molecular mechanisms for these poorer outcomes.
OBJECTIVES: The purpose of the present study was to determine whether racial disparity exists between African American (AA) and non-African American (NAA) patients with uterine endometrioid carcinoma who received similar multidisciplinary management. METHODS: We identified 766 patients with endometrioid adenocarcinoma 2009 FIGO stages I-II who underwent hysterectomy. Patients were divided into two groups; AA and NAA. Recurrence-free survival (RFS), disease specific survival (DSS) and overall survival (OS) for two groups were calculated. RESULTS: Median follow-up was 5.1 years. 27% were AA and 73% were NAA. All patients underwent hysterectomy and oophorectomy. 80% had peritoneal cytology examination and 69% underwent lymphadenectomy. AA patients were more likely to have higher grade tumors, and higher incidence of lymphovascular space involvement (LVSI). Although the two groups were balanced with regards to surgical staging and adjuvant treatment received, the 5-year RFS and DSS were significantly lower in AA compared to NAApatients (91% vs 84%, p=0.030; 95% vs 88%, p=0.011, respectively). Overall survival was not significantly different between the two groups. On multivariate analysis, after adjusting for other prognostic factors, race (AA vs NAA) was not a significant predictor of outcome. Grade 3 tumors and the presence of LVSI were the only two independent predictors of RFS and DSS with p ≤ 0.001 and p ≤ 0.001, respectively. CONCLUSION: In this large hospital-based study, AA race was associated with a higher incidence of adverse pathological features and worse recurrence-free and disease-specific survival. However, on multivariate analysis race was not an independent prognostic factor. Further studies are needed to elucidate possible underlying molecular mechanisms for these poorer outcomes.
Authors: Christopher M Tarney; Chunqiao Tian; Guisong Wang; Elizabeth A Dubil; Nicholas W Bateman; John K Chan; Mohamed A Elshaikh; Michele L Cote; Joellen M Schildkraut; Craig D Shriver; Thomas P Conrads; Chad A Hamilton; G Larry Maxwell; Kathleen M Darcy Journal: Gynecol Oncol Date: 2017-08-08 Impact factor: 5.482
Authors: Ashley S Felix; David E Cohn; Theodore M Brasky; Richard Zaino; Kay Park; David G Mutch; William T Creasman; Premal H Thaker; Joan L Walker; Richard G Moore; Shashikant B Lele; Saketh R Guntupalli; Levi S Downs; Christa I Nagel; John F Boggess; Michael L Pearl; Olga B Ioffe; Marcus E Randall; Louise A Brinton Journal: Am J Obstet Gynecol Date: 2018-08-07 Impact factor: 8.661
Authors: A S Felix; T M Brasky; D E Cohn; D G Mutch; W T Creasman; P H Thaker; J L Walker; R G Moore; S B Lele; S R Guntupalli; L S Downs; Ci Nagel; J F Boggess; M L Pearl; O B Ioffe; W Deng; D S Miller; L A Brinton Journal: Int J Cancer Date: 2017-11-06 Impact factor: 7.396
Authors: David A Barrington; Jennifer A Sinnott; Danaye Nixon; Tasleem J Padamsee; David E Cohn; Kemi M Doll; Macarius M Donneyong; Ashley S Felix Journal: Am J Obstet Gynecol Date: 2022-03-10 Impact factor: 10.693