Type II endometrial cancer in Hispanic women: tumor characteristics, treatment and survival compared to non-Hispanic white women

Gynecol Oncol. 2014 Jun;133(3):512-7. doi: 10.1016/j.ygyno.2014.03.562. Epub 2014 Mar 24.

Abstract

Objectives: To compare survival of Hispanic white (HW) and non-Hispanic white (NHW) women with type II endometrial adenocarcinoma (EC).

Methods: Patients with serous, clear cell or grade 3 endometrioid EC were identified from the Surveillance, Epidemiology, and End Results (SEER) program 1988-2009 and were divided into HW and NHW. HW were subdivided into natives and immigrants.

Results: Of the 14,434 women, 13,012 (90.2%) were NHW and 1422 (9.8%) were HW. HW were younger than NHW (mean 63 vs. 68years, p<0.001). A higher proportion of HW presented with late stage disease than NHW (43.8% vs. 36.6%, p=0.04). Performing lymphadenectomy was not different but HW were more likely to have positive lymph nodes than NHW (27.6% vs. 23.1%, p=0.02). Further, HW were less likely to receive radiation than NHW (39.5% vs. 42.3%, p=0.04). No difference in clinicopathologic characteristics was found between immigrant and native HW. In multivariate models adjusting for age, stage, histology, surgical treatment, extent of lymphadenectomy, and radiation therapy, no difference in overall survival (OS) (HR 1.06, 95% CI 0.97-1.16, p=0.19) and cancer-specific survival (CSS) (HR 1.02, 95% CI 0.91-1.14, p=0.75) was found between HW and NHW. Interestingly, immigrant HW had better OS (HR 0.74, 95% CI 0.62-0.89, p<0.001) and CSS (HR 0.72, 95% CI 0.58-0.90, P=0.003) than native HW.

Conclusions: Although they were more likely to present with advanced stage and positive nodal disease, no difference in outcome was noted between Hispanic and non-Hispanic whites with EC. Interestingly, immigrant HW had more favorable outcome compared to native HW.

Keywords: Hispanic whites; Non-Hispanic whites; Place of birth; Racial disparity; Survival; Type II endometrial cancer.

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / pathology*
  • Adenocarcinoma / therapy
  • Adenocarcinoma, Clear Cell / mortality
  • Adenocarcinoma, Clear Cell / pathology
  • Adenocarcinoma, Clear Cell / therapy
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Endometrioid / mortality
  • Carcinoma, Endometrioid / pathology
  • Carcinoma, Endometrioid / therapy
  • Emigrants and Immigrants*
  • Endometrial Neoplasms / mortality
  • Endometrial Neoplasms / pathology*
  • Endometrial Neoplasms / therapy
  • European Continental Ancestry Group*
  • Female
  • Health Status Disparities*
  • Healthcare Disparities / ethnology*
  • Hispanic Americans*
  • Humans
  • Hysterectomy / statistics & numerical data
  • Lymph Node Excision*
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Grading
  • Neoplasm Staging
  • Radiotherapy, Adjuvant
  • SEER Program
  • Treatment Outcome
  • United States
  • Young Adult