TY - JOUR
T1 - Racial disparities in uterine clear cell carcinoma
T2 - A multi-institution study
AU - Al-Wahab, Zaid R.
AU - Kumar, Sanjeev
AU - Mutch, David G.
AU - Dowdy, Sean C.
AU - Hensley, Sharon A.
AU - Wang, Yun
AU - Mahdi, Hidar
AU - Ali-Fehmi, Rouba
AU - Morris, Robert T.
AU - Elshaikh, Mohammed
AU - Munkarah, Adnan R.
PY - 2014/3
Y1 - 2014/3
N2 - Objective: The aim of this study was to evaluate the impact of race on the overall survival (OS) and progression-free survival (PFS) of white and African-American patients with uterine clear cell carcinoma (UCCC). Methods: A retrospective review was conducted of all primary UCCC cases treated at 1 of 4 major gynecologic cancer centers between 1982 and 2012. Patients and tumor characteristics were retrieved from the cancer databases of the respective institutions and based on a retrospective review of the medical records. Differences in the OS and PFS between African-American and white women were compared using the Kaplan-Meier curves and log-rank test for univariate analysis. Cox regression models for the multivariate analyses were built to evaluate the relative impact of the various prognostic factors. Results: One hundred seventy women with UCCC were included in the study, including 118 white and 52 African-American women. Both groups were comparable with respect to age (P = 0.9), stage at diagnosis (P = 0.34), angiolymphatic invasion (P = 0.3), and depth of myometrial invasion (P = 0.84). In the multivariate analyses for known prognostic factors, OS and PFS were significantly different between white and African-American patients in the early-stage disease (hazard ratio [HR], 5.4; 95% confidence interval [CI], 1.2-23.2; P = 0.023 and HR, 3.5; 95% CI, 1.60-7.77; P = 0.0016, respectively) but not in the advancedstage disease (HR, 0.83; 95% CI, 0.40-1.67; P = 0.61 and HR, 1.5; 95% CI, 0.84-2.78; P = 0.15, respectively). Conclusions: In the current study, African-American patients have a prognosis worse than that of white patients in early-stage UCCC. We could not prove the same difference in advanced-stage disease.
AB - Objective: The aim of this study was to evaluate the impact of race on the overall survival (OS) and progression-free survival (PFS) of white and African-American patients with uterine clear cell carcinoma (UCCC). Methods: A retrospective review was conducted of all primary UCCC cases treated at 1 of 4 major gynecologic cancer centers between 1982 and 2012. Patients and tumor characteristics were retrieved from the cancer databases of the respective institutions and based on a retrospective review of the medical records. Differences in the OS and PFS between African-American and white women were compared using the Kaplan-Meier curves and log-rank test for univariate analysis. Cox regression models for the multivariate analyses were built to evaluate the relative impact of the various prognostic factors. Results: One hundred seventy women with UCCC were included in the study, including 118 white and 52 African-American women. Both groups were comparable with respect to age (P = 0.9), stage at diagnosis (P = 0.34), angiolymphatic invasion (P = 0.3), and depth of myometrial invasion (P = 0.84). In the multivariate analyses for known prognostic factors, OS and PFS were significantly different between white and African-American patients in the early-stage disease (hazard ratio [HR], 5.4; 95% confidence interval [CI], 1.2-23.2; P = 0.023 and HR, 3.5; 95% CI, 1.60-7.77; P = 0.0016, respectively) but not in the advancedstage disease (HR, 0.83; 95% CI, 0.40-1.67; P = 0.61 and HR, 1.5; 95% CI, 0.84-2.78; P = 0.15, respectively). Conclusions: In the current study, African-American patients have a prognosis worse than that of white patients in early-stage UCCC. We could not prove the same difference in advanced-stage disease.
KW - African American
KW - Clear cell carcinoma
KW - Clear cell endometrial cancer
KW - Race
KW - Racial disparities
KW - Survival
KW - Uterine clear cell carcinoma
KW - White
UR - http://www.scopus.com/inward/record.url?scp=84900421183&partnerID=8YFLogxK
U2 - 10.1097/IGC.0000000000000068
DO - 10.1097/IGC.0000000000000068
M3 - Article
C2 - 24552897
AN - SCOPUS:84900421183
SN - 1048-891X
VL - 24
SP - 541
EP - 548
JO - International Journal of Gynecological Cancer
JF - International Journal of Gynecological Cancer
IS - 3
ER -