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Racial disparity in survival among patients with advanced/recurrent endometrial adenocarcinoma: a Gynecologic Oncology Group study.

Abstract

BACKGROUND

Previous studies have reported shorter survival of black women compared with white women who had advanced/recurrent endometrial cancer. It has been suggested that this may reflect racially based differences in treatment.

METHODS

The authors retrospectively reviewed data from 169 black women and 982 white women with International Federation of Gynecologic Oncology (FIGO) Stage III, Stage IV, or recurrent endometrial carcinoma who were participants in 1 of 4 Gynecologic Oncology Group randomized treatment trials of doxorubicin alone or combined with paclitaxel and/or cisplatin. Demographic, histologic, treatment, and outcome data were analyzed to estimate survival, and between-group comparisons were performed.

RESULTS

The pooled data revealed that black women were more likely to have papillary serous histology (P < .001), Stage IV disease (P < .001), and higher tumor grade (P < .001) compared with white women, and survival was worse among black women than among white women (median survival, 10.6 months vs. 12.2 months, respectively; P < .001). A Cox proportional hazards regression analysis that was adjusted for performance status, disease stage, tumor histology, tumor grade, and treatment demonstrated worse survival for black women (hazards ratio, 1.26, 95% confidence interval, 1.06-1.51; P = .010).

CONCLUSIONS

The data from a large group of women with advanced/recurrent endometrial cancer suggested that a racial disparity in survival persists, despite the finding that black women and white women received similar treatment. Although the causes of racial disparity in endometrial cancer remain to be elucidated, socioeconomic, biologic, and cultural factors should be investigated to identify the etiologic origins of this multifactorial healthcare problem.

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  • Authors+Show Affiliations

    ,

    Division of Gynecologic Oncology, Department of Obstetrics and Gynecology and the U.S. Military Cancer Institute, Walter Reed Army Medical Center, Washington, DC, USA.

    , , , , , , , ,

    Source

    Cancer 107:9 2006 Nov 01 pg 2197-205

    MeSH

    Adenocarcinoma
    African Americans
    Antineoplastic Combined Chemotherapy Protocols
    Endometrial Neoplasms
    European Continental Ancestry Group
    Female
    Follow-Up Studies
    Humans
    Neoplasm Recurrence, Local
    Neoplasm Staging
    Randomized Controlled Trials as Topic
    Survival Analysis

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    17001661

    Citation

    Maxwell, G Larry, et al. "Racial Disparity in Survival Among Patients With Advanced/recurrent Endometrial Adenocarcinoma: a Gynecologic Oncology Group Study." Cancer, vol. 107, no. 9, 2006, pp. 2197-205.
    Maxwell GL, Tian C, Risinger J, et al. Racial disparity in survival among patients with advanced/recurrent endometrial adenocarcinoma: a Gynecologic Oncology Group study. Cancer. 2006;107(9):2197-205.
    Maxwell, G. L., Tian, C., Risinger, J., Brown, C. L., Rose, G. S., Thigpen, J. T., ... Brewster, W. R. (2006). Racial disparity in survival among patients with advanced/recurrent endometrial adenocarcinoma: a Gynecologic Oncology Group study. Cancer, 107(9), pp. 2197-205.
    Maxwell GL, et al. Racial Disparity in Survival Among Patients With Advanced/recurrent Endometrial Adenocarcinoma: a Gynecologic Oncology Group Study. Cancer. 2006 Nov 1;107(9):2197-205. PubMed PMID: 17001661.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Racial disparity in survival among patients with advanced/recurrent endometrial adenocarcinoma: a Gynecologic Oncology Group study. AU - Maxwell,G Larry, AU - Tian,Chunqiao, AU - Risinger,John, AU - Brown,Carol L, AU - Rose,G Scott, AU - Thigpen,J Tate, AU - Fleming,Gini F, AU - Gallion,Holly H, AU - Brewster,Wendy R, AU - ,, PY - 2006/9/27/pubmed PY - 2006/12/21/medline PY - 2006/9/27/entrez SP - 2197 EP - 205 JF - Cancer JO - Cancer VL - 107 IS - 9 N2 - BACKGROUND: Previous studies have reported shorter survival of black women compared with white women who had advanced/recurrent endometrial cancer. It has been suggested that this may reflect racially based differences in treatment. METHODS: The authors retrospectively reviewed data from 169 black women and 982 white women with International Federation of Gynecologic Oncology (FIGO) Stage III, Stage IV, or recurrent endometrial carcinoma who were participants in 1 of 4 Gynecologic Oncology Group randomized treatment trials of doxorubicin alone or combined with paclitaxel and/or cisplatin. Demographic, histologic, treatment, and outcome data were analyzed to estimate survival, and between-group comparisons were performed. RESULTS: The pooled data revealed that black women were more likely to have papillary serous histology (P < .001), Stage IV disease (P < .001), and higher tumor grade (P < .001) compared with white women, and survival was worse among black women than among white women (median survival, 10.6 months vs. 12.2 months, respectively; P < .001). A Cox proportional hazards regression analysis that was adjusted for performance status, disease stage, tumor histology, tumor grade, and treatment demonstrated worse survival for black women (hazards ratio, 1.26, 95% confidence interval, 1.06-1.51; P = .010). CONCLUSIONS: The data from a large group of women with advanced/recurrent endometrial cancer suggested that a racial disparity in survival persists, despite the finding that black women and white women received similar treatment. Although the causes of racial disparity in endometrial cancer remain to be elucidated, socioeconomic, biologic, and cultural factors should be investigated to identify the etiologic origins of this multifactorial healthcare problem. SN - 0008-543X UR - https://www.unboundmedicine.com/medline/citation/17001661/Racial_disparity_in_survival_among_patients_with_advanced/recurrent_endometrial_adenocarcinoma:_a_Gynecologic_Oncology_Group_study_ L2 - https://doi.org/10.1002/cncr.22232 DB - PRIME DP - Unbound Medicine ER -