3 years ago

Endometrial carcinoma recurrence according to race and ethnicity: An NRG Oncology/Gynecologic Oncology Group 210 Study

SR Guntupalli, SB Lele, DE Cohn, CI Nagel, LS Downs, JL Walker, OB Ioffe, ML Pearl, TM Brasky, DS Miller, W Deng, WT Creasman, DG Mutch, RG Moore, PH Thaker, AS Felix, JF Boggess, LA Brinton
Non-Hispanic black (NHB) women are more likely to experience an endometrial carcinoma (EC) recurrence compared with Non-Hispanic white (NHW) women. The extent to which tumor characteristics, socioeconomic status (SES), and treatment contribute to this observation is not well defined. In the NRG Oncology/Gynecology Oncology Group (GOG) 210 Study we evaluated associations between race and ethnicity with EC recurrence according to tumor characteristics with adjustment for potential confounders. Our analysis included 3,199 non-Hispanic white, 532 non-Hispanic black and 232 Hispanic women with EC. Recurrence was documented during follow-up. We used Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between race and ethnicity with EC recurrence in models stratified by histologic subtype (low-grade endometrioid, high-grade endometrioid, serous, mixed cell, carcinosarcoma, clear cell) or stage (I, II, III) and adjusted for age, SES, body mass index, smoking status, and treatment. In histologic subtype-stratified models, higher EC recurrence was noted in NHB women with low-grade endometrioid (HR=1.94, 95% CI=1.21-3.10) or carcinosarcomas (HR=1.66, 95% CI=0.99-2.79) compared with NHWs. In stage-stratified models, higher EC recurrence was noted among NHB women with stage I (HR=1.48, 95% CI=1.06-2.05) and Hispanic women with stage III disease (HR=1.81, 95% CI=1.11-2.95). Our observations of higher EC recurrence risk among NHB and Hispanic women, as compared with NHW women, were not explained by tumor characteristics, SES, treatment or other confounders. Other factors, such as racial differences in tumor biology or other patient factors, should be explored as contributors to racial disparities in EC recurrence. This article is protected by copyright. All rights reserved.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1002/ijc.31127

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