RELATIONSHIP BETWEEN RACE AND INTERVAL TO TREATMENT IN ENDOMETRIAL CANCER
RELATIONSHIP BETWEEN RACE AND INTERVAL TO TREATMENT IN ENDOMETRIAL CANCER
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DOI：
10.1016/s0029-7844(95)80002-6
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发表时间：
1995-10-01
影响因子：
7.2
通讯作者：
BERCHUCK, A
中科院分区：
文献类型：
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作者：
LIU, JR;CONAWAY, M;BERCHUCK, A
目的：探讨黑人妇女子宫内膜腺癌预后不良是否与异常子宫出血发病与子宫切除术时间间隔的种族差异有关。方法：回顾我院1990-1993年间接受子宫内膜癌手术治疗的219例患者（176例白人，39例黑人，4例其他）的临床资料，了解其临床病理特征。此外，注意到异常子宫出血和子宫切除术之间的时间间隔。结果：与白人患者相比，患有子宫内膜癌的黑人女性具有明显更高的不良特征发生率，包括非子宫内膜样组织学（38对12%），III期或IV期疾病（51对19%），3级分化（49对18%）和较差的生存率（P = 0.003）。黑人（11.1周）和白人（13.7周）从异常子宫出血到子宫切除术的中位间隔无显著差异，治疗间隔也与分期、分级、组织学类型、子宫肌层浸润或生存期无关。相比之下，与未使用激素的患者相比，有激素使用史的患者从异常出血开始到治疗的中位间隔更长（19周对10周）（P < 0.01），并且激素使用与有利的临床病理特征和生存相关。虽然黑人妇女使用激素的可能性低于白人妇女（13%对44%）（P < 0.001），但在纠正激素使用后，在分期、分级和生存方面的种族差异仍然存在。结论：本研究证实，患有子宫内膜癌的黑人妇女的预后比白人妇女差；然而，这似乎不是由于从异常子宫出血开始到子宫切除术的时间间隔的差异。
Objective: To determine whether the poor prognosis of black women with endometrial adenocarcinoma is due to racial differences in the interval between the onset of abnormal uterine bleeding and hysterectomy.Methods: Clinical records of all 219 patients (176 white, 39 black, four other) who underwent surgical treatment of endometrial cancer during 1990-1993 at our institution were reviewed to obtain information regarding clinicopathologic features. In addition, the interval between the onset of abnormal uterine bleeding and hysterectomy was noted.Results: Compared with white patients, black women with endometrial cancer had a significantly higher incidence of unfavorable features, including non-endometrioid histology (38 versus 12%), stage III or IV disease (51 versus 19%), grade 3 differentiation (49 versus 18%), and poor survival (P = .003). There was no significant difference in the median interval from onset of abnormal uterine bleeding to hysterectomy between blacks (11.1 weeks) and whites (13.7 weeks), nor was the interval to treatment related to stage, grade, histologic type, myometrial invasion, or survival. In contrast, patients with a history of hormone use had a longer median interval from the onset of abnormal bleeding to treatment compared with patients who had not used hormones (19 versus 10 weeks) (P < .01), and hormone use was associated with favorable clinicopathologic features and survival. Although black women were less likely to have used hormones than white women (13 versus 44%) (P < .001), racial differences in stage, grade, and survival persisted after correcting for hormone use.Conclusion: This study confirms that black women with endometrial cancer have a poorer outcome than white women; however, this does not appear to be due to a difference in the interval from onset of abnormal uterine bleeding to hysterectomy.