This article is a US Government work and, as such, is in the public domain in the United States of America.
A Gynecologic Oncology Group study
Version of Record online: 25 SEP 2006
Published 2006 American Cancer Society
Volume 107, Issue 9, pages 2197–2205, 1 November 2006
How to Cite
Maxwell, G. L., Tian, C., Risinger, J., Brown, C. L., Rose, G. S., Thigpen, J. T., Fleming, G. F., Gallion, H. H. and Brewster, W. R. (2006), Racial disparity in survival among patients with advanced/recurrent endometrial adenocarcinoma. Cancer, 107: 2197–2205. doi: 10.1002/cncr.22232
Presented in part as an oral presentation at the 36th Annual Meeting of the Society of Gynecologic Oncologists, Miami, Florida, 2005, and as the Best of Oncology 2005 at the Annual Meeting of the American Society of Clinical Oncology, Orlando, Florida, 2005.
The following Gynecologic Oncology Group member institutions participated in the primary treatment studies: Wake Forest University School of Medicine, Columbus Cancer Council, University of California Medical Center at Irvine, Duke University Medical Center, Wayne State University, Indiana University Medical Center, University of Kentucky, Washington University School of Medicine, Abington Memorial Hospital, University of Iowa Hospitals and Clinics, Tufts-New England Medical Center, University of Mississippi Medical Center, Milton S. Hershey Medical Center, Rush-Presbyterian-St. Luke's Medical Center, Albany Medical College, University of Texas Southwestern Medical Center at Dallas, Community Clinical Oncology Program, University of Oklahoma, University of Minnesota Medical School, University of Virginia, The Cleveland Clinic Foundation, University of Alabama at Birmingham, Colorado Gynecologic Oncology Group, University of North Carolina School of Medicine, University of Massachusetts Medical School, Fox Chase Cancer Center, Women's Cancer Center, State University of New York at Stony Brook, Medical University of South Carolina, Johns Hopkins Oncology Center, Cooper Hospital/University Medical Center, University of Chicago, Walter Reed Army Medical Center, Tampa Bay Cancer Consortium, University of Rochester Medical Center, Eastern Pennsylvania GYN/ONC Center, Tacoma General Hospital, Thomas Jefferson University Hospital, Case Western Reserve University, University of Cincinnati, University of Pennsylvania Cancer Center, Gynecologic Oncology Network, Georgetown University Hospital, Mayo Clinic, Oregon Health Sciences University, University of Miami School of Medicine, University of California at Los Angeles, State University of New York Upstate Medical Center, Eastern Virginia Medical School, The University of Texas M. D. Anderson Cancer Center, Ellis Fischel Cancer Center, State University of New York Downstate Medical Center, Emory University Clinic, University of Southern California at Los Angeles, Stanford University Medical Center, Memorial Sloan-Kettering Cancer Center, University of Washington, North Shore University Hospital, and Long Island Jewish Medical Center
The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.
Denise Mackey, Gynecologic Oncology Group/Four Penn Center, 1600 JFK Boulevard, Suite 1020, Philadelphia, PA 19103; Fax: (716) 845-1064; E-mail: firstname.lastname@example.org
- Issue online: 24 OCT 2006
- Version of Record online: 25 SEP 2006
- Manuscript Accepted: 25 JUL 2006
- Manuscript Revised: 24 JUL 2006
- Manuscript Received: 4 JUN 2006
- National Cancer Institute grants to the Gynecologic Oncology Group Administrative Office. Grant Number: CA 27469
- The Gynecologic Oncology Group Statistical Office. Grant Number: CA 37517
- endometrial cancer;
- racial disparity;
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.
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.
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).
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. Cancer 2006. Published 2006 by the American Cancer Society