RACIAL-DIFFERENCES IN SURGICALLY STAGED PATIENTS WITH ENDOMETRIAL CANCER

This study examined whether differences in survival for endometrial ca ncer attributed to race are primarily associated with socioeconomic st atus, comorbid illnesses, molecular genetic alterations, and other dis ease-related characteristics identified as poor prognostic factors. On e hundred fifty-two surgically staged patients with endometrial cancer (37 African-American and 115 European-American women) treated from 19 90 to 1994 were analyzed for differences in demographics, disease-rela ted characteristics, and survival. Survival was poorer for African-Ame rican women than for European-American women. African-American women h ad lower socioeconomic status and a higher prevalence of poor prognost ic factors. Surgical stage, positive peritoneal cytology, angiolymphat ic invasion, cervical stromal involvement, and a history of other mali gnancies were similar between the two groups. The most important predi ctors of survival were age at diagnosis, surgical stage, myometrial in vasion, positive peritoneal cytology, cervical stromal involvement, tu mor grade, aneuploidy, histology, S-phase fraction, number of poor pro gnostic factors, and race. Racial differences in survival were not exp lained by socioeconomic status, comorbid illnesses, or estrogen use. W hen incorporating the number of poor prognostic factors in a survival model with race and surgical stage, race ceased to be of significant p rognostic value. In an analysis restricted to women with poor prognost ic factors, this phenomena also occurred after adjusting for the numbe r of poor prognostic factors. These findings suggest that the cumulati ve number of poor prognostic factors, not race, is a more important pr edictor of survival in endometrial cancer.