The Impact of Racial Disparities on Outcome in Patients With Stage IIIC Endometrial Carcinoma: A Pooled Data Analysis.

Autor:	Patrich T; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ., Wang Y; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ., Elshaikh MA; Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit., Zhu S; Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit., Damast S; Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT., Li JY; Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT., Fields EC; Department of Radiation Oncology, Virginia Commonwealth University Health System, Massey Cancer Center, Richmond, VA., Beriwal S; Allegheney Health Network., Keller A; Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh., Kidd EA; Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA., Usoz M; Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA., Jolly S; Department of Radiation Oncology, University of Michigan, Ann Arbor, MI., Jaworski E; Department of Radiation Oncology, University of Michigan, Ann Arbor, MI., Leung EW; Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada., Taunk NK; Department of Radiation Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA., Chino J; Department of Radiation Oncology, Duke University Medical Center, Durham, NC., Russo AL; Department of Radiation Oncology, Massachusetts General Hospital., Lea JS; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX., Lee LJ; Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA., Albuquerque KV; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX., Hathout L; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ.
Jazyk:	angličtina
Zdroj:	American journal of clinical oncology [Am J Clin Oncol] 2023 Mar 01; Vol. 46 (3), pp. 114-120. Date of Electronic Publication: 2023 Jan 10.
DOI:	10.1097/COC.0000000000000975
Abstrakt:	Objective: To report the impact of race on clinical outcomes in patients with stage IIIC endometrial carcinoma. Materials and Methods: A retrospective multi-institutional study included 90 black and 568 non-black patients with stage IIIC endometrial carcinoma who received adjuvant chemotherapy and radiation treatments. Overall survival (OS) and recurrence-free survival (RFS) were calculated by the Kaplan-Meier method. Propensity score matching (PSM) was conducted. Statistical analyses were conducted using SPSS version 27. Results: The Median follow-up was 45.3 months. black patients were significantly older, had more nonendometrioid histology, grade 3 tumors, and were more likely to have >1 positive paraaortic lymph nodes compared with non-black patients (all P <0.0001). The 5-year estimated OS and RFS rates were 45% and 47% compared with 77% and 68% for black patients versus non-black patients, respectively ( P <0.001). After PSM, the 2 groups were well-balanced for all prognostic covariates. The estimated hazard ratios of black versus non-black patients were 1.613 ( P value=0.045) for OS and 1.487 ( P value=0.116) for RFS. After PSM, black patients were more likely to receive the "Sandwich" approach and concurrent chemoradiotherapy compared with non-black ( P =0.013) patients. Conclusions: Black patients have higher rates of nonendometrioid histology, grade 3 tumors, and number of involved paraaortic lymph nodes, worse OS, and RFS, and were more likely to receive the "Sandwich" approach compared with non-black patients. After PSM, black patients had worse OS with a nonsignificant trend in RFS. Access to care, equitable inclusion on randomized trials, and identification of genomic differences are warranted to help mitigate disparities. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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