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Asian-Pacific Islander race independently predicts poor outcome in patients with endometrial cancer.

Abstract

OBJECTIVE

The Department of Defense health care system provides access to care without respect to age, race, or socioeconomic status. We sought to determine the effect of race as a predictor of survival in patients with endometrial cancer treated in the Department of Defense medical system.

METHODS

Information on patients with endometrial carcinoma was extracted from the Department of Defense centralized tumor registry for the period 1988 to 1995. Data included age at diagnosis, military status, race, tumor histology, grade, FIGO surgical stage, adjuvant therapies, and disease-free survival. The chi(2) test was used for analysis of prognostic factors and adjuvant treatments between racial groups. Actuarial survival curves were calculated by using the method of Kaplan and Meier and compared by the log-rank test. Variables found to be significant on univariate analysis (P < 0.05) were entered into a multivariate Cox regression analysis.

RESULTS

Of 1811 patients meeting criteria for the study, racial distribution was 90% Caucasian, 4.4% African-American, and 5.5% Asian-Pacific Islander. African-Americans had more advanced stages of disease compared to Caucasians (P < 0.001). Both African-Americans and Asian-Pacific Islanders had higher grade tumors and less favorable histologic types than Caucasians (P < 0.05). The extent of adjuvant therapies was similar for racial groups. African-Americans and Asian-Pacific Islanders had significantly worse 5-year disease-free survivals than Caucasians (P = 0.007). Additional poor prognostic factors included age >60 years, grade, unfavorable histology, and stage. On multivariate analysis age >60 years, stage, and Asian-Pacific Islander race remained significant prognostic factors.

CONCLUSION

African-Americans and Asian-Pacific Islanders had worse survivals than Caucasians. After controlling for imbalances in clinicopathologic factors, Asian-Pacific Islander race was found to be a newly identified poor prognostic factor.

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  • Authors+Show Affiliations

    ,

    Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Brooke Army Medical Center, Fort Sam Houston, TX 78234-6200, USA. edward.kost@cen.amedd.army.mil

    , , , , , , ,

    Source

    Gynecologic oncology 89:2 2003 May pg 218-26

    MeSH

    Asian Americans
    Endometrial Neoplasms
    Female
    Humans
    Middle Aged
    Neoplasm Staging
    Prognosis
    Survival Rate
    Treatment Outcome

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    12713983

    Citation

    Kost, Edward R., et al. "Asian-Pacific Islander Race Independently Predicts Poor Outcome in Patients With Endometrial Cancer." Gynecologic Oncology, vol. 89, no. 2, 2003, pp. 218-26.
    Kost ER, Hall KL, Hines JF, et al. Asian-Pacific Islander race independently predicts poor outcome in patients with endometrial cancer. Gynecol Oncol. 2003;89(2):218-26.
    Kost, E. R., Hall, K. L., Hines, J. F., Farley, J. H., Nycum, L. R., Rose, G. S., ... Kendall, B. S. (2003). Asian-Pacific Islander race independently predicts poor outcome in patients with endometrial cancer. Gynecologic Oncology, 89(2), pp. 218-26.
    Kost ER, et al. Asian-Pacific Islander Race Independently Predicts Poor Outcome in Patients With Endometrial Cancer. Gynecol Oncol. 2003;89(2):218-26. PubMed PMID: 12713983.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Asian-Pacific Islander race independently predicts poor outcome in patients with endometrial cancer. AU - Kost,Edward R, AU - Hall,Kevin L, AU - Hines,Jeffrey F, AU - Farley,John H, AU - Nycum,Lawrence R, AU - Rose,G Scott, AU - Carlson,Jay W, AU - Fischer,Joseph R,Jr AU - Kendall,Brian S, PY - 2003/4/26/pubmed PY - 2003/6/5/medline PY - 2003/4/26/entrez SP - 218 EP - 26 JF - Gynecologic oncology JO - Gynecol. Oncol. VL - 89 IS - 2 N2 - OBJECTIVE: The Department of Defense health care system provides access to care without respect to age, race, or socioeconomic status. We sought to determine the effect of race as a predictor of survival in patients with endometrial cancer treated in the Department of Defense medical system. METHODS: Information on patients with endometrial carcinoma was extracted from the Department of Defense centralized tumor registry for the period 1988 to 1995. Data included age at diagnosis, military status, race, tumor histology, grade, FIGO surgical stage, adjuvant therapies, and disease-free survival. The chi(2) test was used for analysis of prognostic factors and adjuvant treatments between racial groups. Actuarial survival curves were calculated by using the method of Kaplan and Meier and compared by the log-rank test. Variables found to be significant on univariate analysis (P < 0.05) were entered into a multivariate Cox regression analysis. RESULTS: Of 1811 patients meeting criteria for the study, racial distribution was 90% Caucasian, 4.4% African-American, and 5.5% Asian-Pacific Islander. African-Americans had more advanced stages of disease compared to Caucasians (P < 0.001). Both African-Americans and Asian-Pacific Islanders had higher grade tumors and less favorable histologic types than Caucasians (P < 0.05). The extent of adjuvant therapies was similar for racial groups. African-Americans and Asian-Pacific Islanders had significantly worse 5-year disease-free survivals than Caucasians (P = 0.007). Additional poor prognostic factors included age >60 years, grade, unfavorable histology, and stage. On multivariate analysis age >60 years, stage, and Asian-Pacific Islander race remained significant prognostic factors. CONCLUSION: African-Americans and Asian-Pacific Islanders had worse survivals than Caucasians. After controlling for imbalances in clinicopathologic factors, Asian-Pacific Islander race was found to be a newly identified poor prognostic factor. SN - 0090-8258 UR - https://www.unboundmedicine.com/medline/citation/12713983/Asian_Pacific_Islander_race_independently_predicts_poor_outcome_in_patients_with_endometrial_cancer_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090825803000507 DB - PRIME DP - Unbound Medicine ER -