The complex triad of obesity, diabetes and race in Type I and II endometrial cancers: Prevalence and prognostic significance

Ko, Emily; Walter, Paige; Clark, Leslie H.; Jackson, Amanda; Franasiak, Jason M.; Bolac, C.; Havrilesky, Laura J.; Secord, Angeles Alvarez; Moore, Dominic T.; Gehrig, Paola A.; Bae‐Jump, Victoria L.

doi:10.1016/j.ygyno.2014.01.032

Cited by 54 publications

(58 citation statements)

References 28 publications

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“…Given the significantly higher comorbidity burden and higher BMI found in AA women, compared to NAA women, racial disparities may be more attributable, at least in part, to these comorbidities rather than inherent uterine cancer-related factors. In agreement with other investigators, [19,20], our study suggests that race is not an independent predictor of cancer recurrence in women with early stage EC.…”

Section: Discussionsupporting

confidence: 92%

A Matched Analysis on the Prognostic Impact of Race on Survival Endpoints of Women with Early-Stage Endometrial Cancer

Feldman

Chaugle

Burmeister

et al. 2018

Gynecol Obstet Invest

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Objective: To compare survival endpoints between African American (AA) and non-AA (NAA) women with endometrial carcinoma (EC) stage I–II using a robust matching analysis. Methods and Materials: Patients were matched by stage, grade, adjuvant management (surveillance, vaginal brachytherapy or pelvic radiation treatment), age, and year of hysterectomy. Recurrence-free survival (RFS), disease-specific survival (DSS) and overall survival (OS) were calculated. Results: A total of 758 patients were included. Body mass index and Age-Adjusted Charlson comorbidity index was significantly higher in AA compared to NAA women. There were no significant differences between the AA and NAA groups in regard to 5-year RFS (94 vs. 93%), DSS (96 vs. 98%) or 5-year OS (90 vs. 92%). On multivariate analysis of survival endpoints for the entire study cohort, it was found that race (AA vs. NAA) was not a significant predictor of RFS, DSS, or OS. Grade 3 tumors and the presence of lymphovascular space invasion (LVSI) were the only 2 independent predictors of RFS and DSS, while age-adjusted Charlson comorbidity score, grade 3, stage II and the presence of LVSI were independent predictors of shorter OS. Conclusions: When matched based on the tumor stage, grade, adjuvant treatment, age, and year of surgery, our study suggests that there is no statistically significant difference in any survival endpoints between AA and NAA women with early-stage EC. Based on these data, disparities in outcome likely do not stem from uterine cancer-related causes. The increased comorbidity burden in AA women is likely a factor contributing to the racial disparity in endometrial cancer.

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Section: Discussionsupporting

confidence: 92%

A Matched Analysis on the Prognostic Impact of Race on Survival Endpoints of Women with Early-Stage Endometrial Cancer

Feldman

Chaugle

Burmeister

et al. 2018

Gynecol Obstet Invest

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“…It is somewhat surprising that Hispanic women do not suffer the same excess burden from endometrial cancer, given that rates of obesity and diabetes are similar to NHB women (34). These conditions have been associated with endometrial cancer etiology and, in some studies, with survival, with potential differences by race/ ethnicity and histologic subtype, highlighting the complex underlying biologic pathways involved in carcinogenesis (35)(36)(37)(38)(39).…”

Section: Discussionmentioning

confidence: 99%

The Growing Burden of Endometrial Cancer: A Major Racial Disparity Affecting Black Women

Coté

Ruterbusch

Olson

et al. 2015

Cancer Epidemiology, Biomarkers &Amp; Prevention

199

148

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Background: In contrast with the decreasing incidence seen for most cancers, endometrial cancer has been increasing in the United States. We examined whether the increasing incidence and mortality from endometrial cancer are equally distributed by race/ethnicity and tumor histologic subtype.Methods: Surveillance, Epidemiology, and End Results (SEER) endometrial cancer incidence and mortality data were obtained from 2000 to 2011. Age-adjusted incidence and incidence-based mortality rates, 95% confidence intervals, and annual percent changes (APC) were calculated. Rate ratios were calculated to compare racial/ethnic groups. Five-year relative survival rates were presented to explore survival by stage at diagnosis.Results: Incidence rates for endometrial cancers are rising across all racial/ethnic groups, with the greatest APC seen among non-Hispanic black (NHB) and Asian women (APC, 2.5 for both).

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“…We wanted to test the additive value of tumor size measurement in predicting the risk for stage IIIC-IV endometrial carcinoma by a model that combines preoperative histology with demographic and biochemical factors known to be associated with an advanced disease and poor outcome [8]. Putative high-risk demographic and biochemical factors were: old age [26][27][28][29], normal weight [30,31], anemia [32], leukocytosis [32], thrombocytosis [32], and elevated serum CA125 [33][34][35]. Sensitivity and negative predictive value are the key metrics for a test that is used for the risk-stratification of endometrial carcinomas because their high values reduce false negative results and help to avoid incomplete surgical staging in patients who most likely benefit from lymphadenectomy.…”

Section: Discussionmentioning

confidence: 99%

Risk-stratification of endometrial carcinomas revisited: A combined preoperative and intraoperative scoring system for a reliable prediction of an advanced disease

Tuomi¹,

Pasanen²,

Luomaranta³

et al. 2015

Gynecologic Oncology

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The complex triad of obesity, diabetes and race in Type I and II endometrial cancers: Prevalence and prognostic significance

Cited by 54 publications

References 28 publications

A Matched Analysis on the Prognostic Impact of Race on Survival Endpoints of Women with Early-Stage Endometrial Cancer

A Matched Analysis on the Prognostic Impact of Race on Survival Endpoints of Women with Early-Stage Endometrial Cancer

The Growing Burden of Endometrial Cancer: A Major Racial Disparity Affecting Black Women

Risk-stratification of endometrial carcinomas revisited: A combined preoperative and intraoperative scoring system for a reliable prediction of an advanced disease

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