Racial disparities in uterine clear cell carcinoma

A multi-institution study

Zaid R. Al-Wahab, Sanjeev Kumar, David G. Mutch, Sean Christopher Dowdy, Sharon A. Hensley, Yun Wang, Hidar Mahdi, Rouba Ali-Fehmi, Robert T. Morris, Mohammed Elshaikh, Adnan R. Munkarah

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective: The aim of this study was to evaluate the impact of race on the overall survival (OS) and progression-free survival (PFS) of white and African-American patients with uterine clear cell carcinoma (UCCC). Methods: A retrospective review was conducted of all primary UCCC cases treated at 1 of 4 major gynecologic cancer centers between 1982 and 2012. Patients and tumor characteristics were retrieved from the cancer databases of the respective institutions and based on a retrospective review of the medical records. Differences in the OS and PFS between African-American and white women were compared using the Kaplan-Meier curves and log-rank test for univariate analysis. Cox regression models for the multivariate analyses were built to evaluate the relative impact of the various prognostic factors. Results: One hundred seventy women with UCCC were included in the study, including 118 white and 52 African-American women. Both groups were comparable with respect to age (P = 0.9), stage at diagnosis (P = 0.34), angiolymphatic invasion (P = 0.3), and depth of myometrial invasion (P = 0.84). In the multivariate analyses for known prognostic factors, OS and PFS were significantly different between white and African-American patients in the early-stage disease (hazard ratio [HR], 5.4; 95% confidence interval [CI], 1.2-23.2; P = 0.023 and HR, 3.5; 95% CI, 1.60-7.77; P = 0.0016, respectively) but not in the advancedstage disease (HR, 0.83; 95% CI, 0.40-1.67; P = 0.61 and HR, 1.5; 95% CI, 0.84-2.78; P = 0.15, respectively). Conclusions: In the current study, African-American patients have a prognosis worse than that of white patients in early-stage UCCC. We could not prove the same difference in advanced-stage disease.

Original languageEnglish (US)
Pages (from-to)541-548
Number of pages8
JournalInternational Journal of Gynecological Cancer
Volume24
Issue number3
DOIs
StatePublished - 2014

Fingerprint

African Americans
Carcinoma
Confidence Intervals
Disease-Free Survival
Survival
Multivariate Analysis
Neoplasms
Proportional Hazards Models
Medical Records
Databases

Keywords

  • African American
  • Clear cell carcinoma
  • Clear cell endometrial cancer
  • Race
  • Racial disparities
  • Survival
  • Uterine clear cell carcinoma
  • White

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology
  • Medicine(all)

Cite this

Racial disparities in uterine clear cell carcinoma : A multi-institution study. / Al-Wahab, Zaid R.; Kumar, Sanjeev; Mutch, David G.; Dowdy, Sean Christopher; Hensley, Sharon A.; Wang, Yun; Mahdi, Hidar; Ali-Fehmi, Rouba; Morris, Robert T.; Elshaikh, Mohammed; Munkarah, Adnan R.

In: International Journal of Gynecological Cancer, Vol. 24, No. 3, 2014, p. 541-548.

Research output: Contribution to journalArticle

Al-Wahab, ZR, Kumar, S, Mutch, DG, Dowdy, SC, Hensley, SA, Wang, Y, Mahdi, H, Ali-Fehmi, R, Morris, RT, Elshaikh, M & Munkarah, AR 2014, 'Racial disparities in uterine clear cell carcinoma: A multi-institution study', International Journal of Gynecological Cancer, vol. 24, no. 3, pp. 541-548. https://doi.org/10.1097/IGC.0000000000000068
Al-Wahab, Zaid R. ; Kumar, Sanjeev ; Mutch, David G. ; Dowdy, Sean Christopher ; Hensley, Sharon A. ; Wang, Yun ; Mahdi, Hidar ; Ali-Fehmi, Rouba ; Morris, Robert T. ; Elshaikh, Mohammed ; Munkarah, Adnan R. / Racial disparities in uterine clear cell carcinoma : A multi-institution study. In: International Journal of Gynecological Cancer. 2014 ; Vol. 24, No. 3. pp. 541-548.
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abstract = "Objective: The aim of this study was to evaluate the impact of race on the overall survival (OS) and progression-free survival (PFS) of white and African-American patients with uterine clear cell carcinoma (UCCC). Methods: A retrospective review was conducted of all primary UCCC cases treated at 1 of 4 major gynecologic cancer centers between 1982 and 2012. Patients and tumor characteristics were retrieved from the cancer databases of the respective institutions and based on a retrospective review of the medical records. Differences in the OS and PFS between African-American and white women were compared using the Kaplan-Meier curves and log-rank test for univariate analysis. Cox regression models for the multivariate analyses were built to evaluate the relative impact of the various prognostic factors. Results: One hundred seventy women with UCCC were included in the study, including 118 white and 52 African-American women. Both groups were comparable with respect to age (P = 0.9), stage at diagnosis (P = 0.34), angiolymphatic invasion (P = 0.3), and depth of myometrial invasion (P = 0.84). In the multivariate analyses for known prognostic factors, OS and PFS were significantly different between white and African-American patients in the early-stage disease (hazard ratio [HR], 5.4; 95{\%} confidence interval [CI], 1.2-23.2; P = 0.023 and HR, 3.5; 95{\%} CI, 1.60-7.77; P = 0.0016, respectively) but not in the advancedstage disease (HR, 0.83; 95{\%} CI, 0.40-1.67; P = 0.61 and HR, 1.5; 95{\%} CI, 0.84-2.78; P = 0.15, respectively). Conclusions: In the current study, African-American patients have a prognosis worse than that of white patients in early-stage UCCC. We could not prove the same difference in advanced-stage disease.",
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AU - Al-Wahab, Zaid R.

AU - Kumar, Sanjeev

AU - Mutch, David G.

AU - Dowdy, Sean Christopher

AU - Hensley, Sharon A.

AU - Wang, Yun

AU - Mahdi, Hidar

AU - Ali-Fehmi, Rouba

AU - Morris, Robert T.

AU - Elshaikh, Mohammed

AU - Munkarah, Adnan R.

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N2 - Objective: The aim of this study was to evaluate the impact of race on the overall survival (OS) and progression-free survival (PFS) of white and African-American patients with uterine clear cell carcinoma (UCCC). Methods: A retrospective review was conducted of all primary UCCC cases treated at 1 of 4 major gynecologic cancer centers between 1982 and 2012. Patients and tumor characteristics were retrieved from the cancer databases of the respective institutions and based on a retrospective review of the medical records. Differences in the OS and PFS between African-American and white women were compared using the Kaplan-Meier curves and log-rank test for univariate analysis. Cox regression models for the multivariate analyses were built to evaluate the relative impact of the various prognostic factors. Results: One hundred seventy women with UCCC were included in the study, including 118 white and 52 African-American women. Both groups were comparable with respect to age (P = 0.9), stage at diagnosis (P = 0.34), angiolymphatic invasion (P = 0.3), and depth of myometrial invasion (P = 0.84). In the multivariate analyses for known prognostic factors, OS and PFS were significantly different between white and African-American patients in the early-stage disease (hazard ratio [HR], 5.4; 95% confidence interval [CI], 1.2-23.2; P = 0.023 and HR, 3.5; 95% CI, 1.60-7.77; P = 0.0016, respectively) but not in the advancedstage disease (HR, 0.83; 95% CI, 0.40-1.67; P = 0.61 and HR, 1.5; 95% CI, 0.84-2.78; P = 0.15, respectively). Conclusions: In the current study, African-American patients have a prognosis worse than that of white patients in early-stage UCCC. We could not prove the same difference in advanced-stage disease.

AB - Objective: The aim of this study was to evaluate the impact of race on the overall survival (OS) and progression-free survival (PFS) of white and African-American patients with uterine clear cell carcinoma (UCCC). Methods: A retrospective review was conducted of all primary UCCC cases treated at 1 of 4 major gynecologic cancer centers between 1982 and 2012. Patients and tumor characteristics were retrieved from the cancer databases of the respective institutions and based on a retrospective review of the medical records. Differences in the OS and PFS between African-American and white women were compared using the Kaplan-Meier curves and log-rank test for univariate analysis. Cox regression models for the multivariate analyses were built to evaluate the relative impact of the various prognostic factors. Results: One hundred seventy women with UCCC were included in the study, including 118 white and 52 African-American women. Both groups were comparable with respect to age (P = 0.9), stage at diagnosis (P = 0.34), angiolymphatic invasion (P = 0.3), and depth of myometrial invasion (P = 0.84). In the multivariate analyses for known prognostic factors, OS and PFS were significantly different between white and African-American patients in the early-stage disease (hazard ratio [HR], 5.4; 95% confidence interval [CI], 1.2-23.2; P = 0.023 and HR, 3.5; 95% CI, 1.60-7.77; P = 0.0016, respectively) but not in the advancedstage disease (HR, 0.83; 95% CI, 0.40-1.67; P = 0.61 and HR, 1.5; 95% CI, 0.84-2.78; P = 0.15, respectively). Conclusions: In the current study, African-American patients have a prognosis worse than that of white patients in early-stage UCCC. We could not prove the same difference in advanced-stage disease.

KW - African American

KW - Clear cell carcinoma

KW - Clear cell endometrial cancer

KW - Race

KW - Racial disparities

KW - Survival

KW - Uterine clear cell carcinoma

KW - White

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