Asian-Pacific Islander race independently predicts poor outcome in patients with endometrial cancer

Edward R Kost, Kevin L Hall, Jeffrey F. Hines, John H. Farley, Lawrence R. Nycum, G. Scott Rose, Jay W. Carlson, Joseph R. Fischer, Brian S. Kendall

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objective. The Department of Defense health care system provides access to care without respect to age, race, or socioeconomic status. We sought to determine the effect of race as a predictor of survival in patients with endometrial cancer treated in the Department of Defense medical system. Methods. Information on patients with endometrial carcinoma was extracted from the Department of Defense centralized tumor registry for the period 1988 to 1995. Data included age at diagnosis, military status, race, tumor histology, grade, FIGO surgical stage, adjuvant therapies, and disease-free survival. The χ2 test was used for analysis of prognostic factors and adjuvant treatments between racial groups. Actuarial survival curves were calculated by using the method of Kaplan and Meier and compared by the log-rank test. Variables found to be significant on univariate analysis (P < 0.05) were entered into a multivariate Cox regression analysis. Results. Of 1811 patients meeting criteria for the study, racial distribution was 90% Caucasian, 4.4% African-American, and 5.5% Asian-Pacific Islander. African-Americans had more advanced stages of disease compared to Caucasians (P < 0.001). Both African-Americans and Asian-Pacific Islanders had higher grade tumors and less favorable histologic types than Caucasians (P < 0.05). The extent of adjuvant therapies was similar for racial groups. African-Americans and Asian-Pacific Islanders had significantly worse 5-year disease-free survivals than Caucasians (P = 0.007). Additional poor prognostic factors included age >60 years, grade, unfavorable histology, and stage. On multivariate analysis age >60 years, stage, and Asian-Pacific Islander race remained significant prognostic factors. Conclusion. African-Americans and Asian-Pacific Islanders had worse survivals than Caucasians. After controlling for imbalances in clinicopathologic factors, Asian-Pacific Islander race was found to be a newly identified poor prognostic factor.

Original languageEnglish (US)
Pages (from-to)218-226
Number of pages9
JournalGynecologic Oncology
Volume89
Issue number2
DOIs
StatePublished - May 1 2003
Externally publishedYes

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Endometrial Neoplasms
Survival
Histology
Social Class
African Americans
Disease-Free Survival
Registries
Neoplasms
Multivariate Analysis
Delivery of Health Care
Therapeutics

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Kost, E. R., Hall, K. L., Hines, J. F., Farley, J. H., Nycum, L. R., Rose, G. S., ... Kendall, B. S. (2003). Asian-Pacific Islander race independently predicts poor outcome in patients with endometrial cancer. Gynecologic Oncology, 89(2), 218-226. https://doi.org/10.1016/S0090-8258(03)00050-7

Asian-Pacific Islander race independently predicts poor outcome in patients with endometrial cancer. / Kost, Edward R; Hall, Kevin L; Hines, Jeffrey F.; Farley, John H.; Nycum, Lawrence R.; Rose, G. Scott; Carlson, Jay W.; Fischer, Joseph R.; Kendall, Brian S.

In: Gynecologic Oncology, Vol. 89, No. 2, 01.05.2003, p. 218-226.

Research output: Contribution to journalArticle

Kost, ER, Hall, KL, Hines, JF, Farley, JH, Nycum, LR, Rose, GS, Carlson, JW, Fischer, JR & Kendall, BS 2003, 'Asian-Pacific Islander race independently predicts poor outcome in patients with endometrial cancer', Gynecologic Oncology, vol. 89, no. 2, pp. 218-226. https://doi.org/10.1016/S0090-8258(03)00050-7
Kost, Edward R ; Hall, Kevin L ; Hines, Jeffrey F. ; Farley, John H. ; Nycum, Lawrence R. ; Rose, G. Scott ; Carlson, Jay W. ; Fischer, Joseph R. ; Kendall, Brian S. / Asian-Pacific Islander race independently predicts poor outcome in patients with endometrial cancer. In: Gynecologic Oncology. 2003 ; Vol. 89, No. 2. pp. 218-226.
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abstract = "Objective. The Department of Defense health care system provides access to care without respect to age, race, or socioeconomic status. We sought to determine the effect of race as a predictor of survival in patients with endometrial cancer treated in the Department of Defense medical system. Methods. Information on patients with endometrial carcinoma was extracted from the Department of Defense centralized tumor registry for the period 1988 to 1995. Data included age at diagnosis, military status, race, tumor histology, grade, FIGO surgical stage, adjuvant therapies, and disease-free survival. The χ2 test was used for analysis of prognostic factors and adjuvant treatments between racial groups. Actuarial survival curves were calculated by using the method of Kaplan and Meier and compared by the log-rank test. Variables found to be significant on univariate analysis (P < 0.05) were entered into a multivariate Cox regression analysis. Results. Of 1811 patients meeting criteria for the study, racial distribution was 90{\%} Caucasian, 4.4{\%} African-American, and 5.5{\%} Asian-Pacific Islander. African-Americans had more advanced stages of disease compared to Caucasians (P < 0.001). Both African-Americans and Asian-Pacific Islanders had higher grade tumors and less favorable histologic types than Caucasians (P < 0.05). The extent of adjuvant therapies was similar for racial groups. African-Americans and Asian-Pacific Islanders had significantly worse 5-year disease-free survivals than Caucasians (P = 0.007). Additional poor prognostic factors included age >60 years, grade, unfavorable histology, and stage. On multivariate analysis age >60 years, stage, and Asian-Pacific Islander race remained significant prognostic factors. Conclusion. African-Americans and Asian-Pacific Islanders had worse survivals than Caucasians. After controlling for imbalances in clinicopathologic factors, Asian-Pacific Islander race was found to be a newly identified poor prognostic factor.",
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T1 - Asian-Pacific Islander race independently predicts poor outcome in patients with endometrial cancer

AU - Kost, Edward R

AU - Hall, Kevin L

AU - Hines, Jeffrey F.

AU - Farley, John H.

AU - Nycum, Lawrence R.

AU - Rose, G. Scott

AU - Carlson, Jay W.

AU - Fischer, Joseph R.

AU - Kendall, Brian S.

PY - 2003/5/1

Y1 - 2003/5/1

N2 - Objective. The Department of Defense health care system provides access to care without respect to age, race, or socioeconomic status. We sought to determine the effect of race as a predictor of survival in patients with endometrial cancer treated in the Department of Defense medical system. Methods. Information on patients with endometrial carcinoma was extracted from the Department of Defense centralized tumor registry for the period 1988 to 1995. Data included age at diagnosis, military status, race, tumor histology, grade, FIGO surgical stage, adjuvant therapies, and disease-free survival. The χ2 test was used for analysis of prognostic factors and adjuvant treatments between racial groups. Actuarial survival curves were calculated by using the method of Kaplan and Meier and compared by the log-rank test. Variables found to be significant on univariate analysis (P < 0.05) were entered into a multivariate Cox regression analysis. Results. Of 1811 patients meeting criteria for the study, racial distribution was 90% Caucasian, 4.4% African-American, and 5.5% Asian-Pacific Islander. African-Americans had more advanced stages of disease compared to Caucasians (P < 0.001). Both African-Americans and Asian-Pacific Islanders had higher grade tumors and less favorable histologic types than Caucasians (P < 0.05). The extent of adjuvant therapies was similar for racial groups. African-Americans and Asian-Pacific Islanders had significantly worse 5-year disease-free survivals than Caucasians (P = 0.007). Additional poor prognostic factors included age >60 years, grade, unfavorable histology, and stage. On multivariate analysis age >60 years, stage, and Asian-Pacific Islander race remained significant prognostic factors. Conclusion. African-Americans and Asian-Pacific Islanders had worse survivals than Caucasians. After controlling for imbalances in clinicopathologic factors, Asian-Pacific Islander race was found to be a newly identified poor prognostic factor.

AB - Objective. The Department of Defense health care system provides access to care without respect to age, race, or socioeconomic status. We sought to determine the effect of race as a predictor of survival in patients with endometrial cancer treated in the Department of Defense medical system. Methods. Information on patients with endometrial carcinoma was extracted from the Department of Defense centralized tumor registry for the period 1988 to 1995. Data included age at diagnosis, military status, race, tumor histology, grade, FIGO surgical stage, adjuvant therapies, and disease-free survival. The χ2 test was used for analysis of prognostic factors and adjuvant treatments between racial groups. Actuarial survival curves were calculated by using the method of Kaplan and Meier and compared by the log-rank test. Variables found to be significant on univariate analysis (P < 0.05) were entered into a multivariate Cox regression analysis. Results. Of 1811 patients meeting criteria for the study, racial distribution was 90% Caucasian, 4.4% African-American, and 5.5% Asian-Pacific Islander. African-Americans had more advanced stages of disease compared to Caucasians (P < 0.001). Both African-Americans and Asian-Pacific Islanders had higher grade tumors and less favorable histologic types than Caucasians (P < 0.05). The extent of adjuvant therapies was similar for racial groups. African-Americans and Asian-Pacific Islanders had significantly worse 5-year disease-free survivals than Caucasians (P = 0.007). Additional poor prognostic factors included age >60 years, grade, unfavorable histology, and stage. On multivariate analysis age >60 years, stage, and Asian-Pacific Islander race remained significant prognostic factors. Conclusion. African-Americans and Asian-Pacific Islanders had worse survivals than Caucasians. After controlling for imbalances in clinicopathologic factors, Asian-Pacific Islander race was found to be a newly identified poor prognostic factor.

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