Katherine C Fuh1, James J Java2, John K Chan3, Daniel S Kapp4, Bradley J Monk5, Robert A Burger6, Robert C Young7, David S Alberts8, William P McGuire9, Maurie Markman10, Jeffrey Bell11, Robert F Ozols12, Deborah K Armstrong13, Carol Aghajanian14, Michael A Bookman15, Robert S Mannel16. 1. Department of Gynecologic Oncology, Washington University, St Louis, MO 63110, USA. Electronic address: kfuh@wustl.edu. 2. Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY 14642, USA. 3. Department of Gynecologic Oncology, California Pacific Medical Center/Sutter Cancer Research Consortium/Palo Alto Medical Foundation, San Francisco, CA 94118, USA. Electronic address: chanjohn@sutterhealth.org. 4. Department of Radiation Oncology, Stanford University, Stanford, CA 94305, USA. Electronic address: kapp@reyes.stanford.edu. 5. Department of Gynecologic Oncology, Biltmore Cancer Center, Phoenix, AZ 85016, USA. Electronic address: Bradley.Monk@usoncology.com. 6. Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, PA 19104, USA. Electronic address: Robert.Burger@uphs.upenn.edu. 7. RCY Consulting, Fox Chase Cancer Center, Philadelphia, PA 19111, USA. Electronic address: robert.young@rcymedicine.com. 8. University of Arizona, Tucson, AZ 85724, USA. Electronic address: DAlberts@uacc.arizona.edu. 9. Virginia Commonwealth University Massey Cancer Center, Richmond, VA 980037, USA. Electronic address: wpmcguire@vcu.edu. 10. Eastern Regional Medical Center, Meadowbrook, PA 19046, USA. Electronic address: Maurie.Markman@ctca-hope.com. 11. Ohio Riverside Methodist Hospital, Columbus, OH 43214, USA. 12. Fox Chase Cancer Center, New Hope, PA 18938, USA. Electronic address: robertozols@comcast.net. 13. Department of Medical Oncology, Johns Hopkins Kimmel Cancer Center, Baltimore, MD 21287, USA. Electronic address: armstde@jhmi.edu. 14. Memorial Sloan Kettering, New York, NY 10065, USA. Electronic address: aghajanc@MSKCC.org. 15. Kaiser Permanente, San Francisco, CA 94115, USA. Electronic address: Michael.a.bookman@kp.org. 16. Department of Obstetrics and Gynecology, Peggy and Charles Stephenson Cancer Center - University of Oklahoma, Oklahoma City, OK 73104, USA. Electronic address: Robert-mannel@ouhsc.edu.
Abstract
PURPOSE: To compare patient/tumor characteristics and outcomes of Asians to Caucasian patients with epithelial ovarian cancer. METHODS: Ancillary data were pooled and analyzed from ten prospective randomized front-line Gynecologic Oncology Group clinical trials from 1996 to 2011. Demographic, clinicopathologic features, disease-specific and all-cause survival were analyzed. RESULTS: Of 7914 patients, 7641 were Caucasian and 273 Asian. When compared to Caucasians, Asians were younger at trial enrollment, had a better performance status, earlier-stage cancers (17.2% vs. 8.1% with stage I; p < 0.001), and were more likely to be of clear cell (15.8% vs. 6.2%, p < 0.001) and mucinous (3.3% vs. 1.9%, p < 0.001) histology. Asians had an improved 5-year disease-specific survival of 54.1% compared to 46.1% for Caucasians, p = 0.001. In multivariate analysis, the Asian race remained a significant prognostic factor for all-cause survival (HR: 0.84; 95% CI: 0.72-0.99; p = 0.04). Other factors predictive of improved survival included younger age, better performance status, optimal cytoreduction, earlier stage, non-clear cell histology, and lower grade tumors. CONCLUSION: Asians enrolled into phase III ovarian cancer clinical trials were younger, with better performance status, earlier-stage of disease, and have a greater number of clear cell and mucinous tumors. After adjusting for these prognostic factors, Asians have a better survival compared to Caucasians.
PURPOSE: To compare patient/tumor characteristics and outcomes of Asians to Caucasian patients with epithelial ovarian cancer. METHODS: Ancillary data were pooled and analyzed from ten prospective randomized front-line Gynecologic Oncology Group clinical trials from 1996 to 2011. Demographic, clinicopathologic features, disease-specific and all-cause survival were analyzed. RESULTS: Of 7914 patients, 7641 were Caucasian and 273 Asian. When compared to Caucasians, Asians were younger at trial enrollment, had a better performance status, earlier-stage cancers (17.2% vs. 8.1% with stage I; p < 0.001), and were more likely to be of clear cell (15.8% vs. 6.2%, p < 0.001) and mucinous (3.3% vs. 1.9%, p < 0.001) histology. Asians had an improved 5-year disease-specific survival of 54.1% compared to 46.1% for Caucasians, p = 0.001. In multivariate analysis, the Asian race remained a significant prognostic factor for all-cause survival (HR: 0.84; 95% CI: 0.72-0.99; p = 0.04). Other factors predictive of improved survival included younger age, better performance status, optimal cytoreduction, earlier stage, non-clear cell histology, and lower grade tumors. CONCLUSION: Asians enrolled into phase III ovarian cancer clinical trials were younger, with better performance status, earlier-stage of disease, and have a greater number of clear cell and mucinous tumors. After adjusting for these prognostic factors, Asians have a better survival compared to Caucasians.
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