Racial disparity in survival among patients with advanced/recurrent endometrial adenocarcinoma - A Gynecologic Oncology Group study
Racial disparity in survival among patients with advanced/recurrent endometrial adenocarcinoma - A Gynecologic Oncology Group study
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DOI：
10.1002/cncr.22232
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发表时间：
2006-11-01
期刊：
影响因子：
6.2
通讯作者：
Brewster, Wendy R.
中科院分区：
文献类型：
--
作者：
Maxwell, G. Larry;Tian, Chunqiao;Brewster, Wendy R.
背景。先前的研究报道，与患有晚期/复发子宫内膜癌的白人妇女相比，黑人妇女的生存期较短。有人认为，这可能反映了基于种族的治疗差异。作者回顾性回顾了国际妇科肿瘤联合会（FIGO） III期、IV期或复发性子宫内膜癌的169名黑人妇女和982名白人妇女的数据，这些妇女参加了4个妇科肿瘤组中1个的阿霉素单独或联合紫杉醇和/或顺铂的随机治疗试验。对人口统计学、组织学、治疗和结局数据进行分析以估计生存率，并进行组间比较。汇总数据显示，与白人女性相比，黑人女性更容易出现乳头状浆液组织学（P < 0.001）、IV期疾病（P < 0.001）和更高的肿瘤分级（P < 0.001），黑人女性的生存期比白人女性更差（中位生存期分别为10.6个月和12.2个月，P < 0.001）。经运动状态、疾病分期、肿瘤组织学、肿瘤分级和治疗调整后的Cox比例风险回归分析显示，黑人女性的生存率较差（风险比1.26,95%可信区间1.06-1.51;P = 0.010）。来自一大批晚期/复发子宫内膜癌妇女的数据表明，尽管发现黑人妇女和白人妇女接受相似的治疗，但种族差异在生存率上仍然存在。虽然造成子宫内膜癌种族差异的原因仍有待阐明，但应调查社会经济、生物学和文化因素，以确定这一多因素保健问题的病因。
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.