POOR SURVIVAL OF BLACK PATIENTS IN CARCINOMA OF THE ENDOMETRIUM

Purpose: To compare the prognostic factors and survivals of black and white patients with endometrial carcinoma. Methods and Materials: A re trospective study was undertaken of a total of 290 patients with endom etrial carcinoma who were treated similarly at the Health Science Cent er at Brooklyn and Kings County Hospital Center from 1975 and 1990. On e hundred and thirty-six of 290 (47.2%) were black and 135/290 (46.9%) were white. Well-known prognostic factors affecting endometrial carci noma were studied in black and white group of patients. Their overall survival and comparison of survival in each prognostic group were also estimated using multi-variate analysis. Results: Fifty-four percent o f white patients had Stage I disease, compared to 45.9% in black patie nts. In Stage II, 51.6% were white and 48.4% were black, and in Stage III, 88.89% were black and 11.1% were white patients (p = 0.034). Fift y six percent Grade I patients were white and 44% were black. In grade 2, 53.3% were white and 46.7% were black and in Grade 3 disease, 70.5 % were black and 29.5% were white (p = 0.008). Up to the inner third o f myometrial invasion had occurred in 60.6% of white patients and 39.4 % in black patients. The middle third of the myometrium was invaded in 60.7% of white patients, and 39.3% of black patients. Thirty-seven pe rcent of outer third of myometrial invasion was found in white patient s and 63% in black patients (p = 0.038). Seventy-two percent of positi ve lymph nodes were found in black patients and 28.0% in white patient s (p = 0.01). Sixty-one percent of patients with positive peritoneal c ytology were black as compared to 38.7% in white patients (p = 0.017). The overall ten-year corrected survival for white and black patients was 72% and 40%, respectively (p = 0.0003). Survivals comparisons, whe n stratified by race and each prognostic group, showed statistically s ignificant overall survival differences in favor of white patients. Co nclusion: Black patients with endometrial carcinoma have poor survival . Low socio-economic status (SES) would not explain these findings. Mo re research is required to determine the cause of poor survival in bla ck patients with endometrial carcinoma.