The impact of race on survival in uterine serous carcinoma: A hospital-based study

ObjectiveAlthough less common than endometrioid carcinoma, uterine serous carcinoma (USC) accounts for a disproportionate number of endometrial cancer-related deaths. It is relatively more common in black compared to white women. The aim of our study is to analyze the impact of race on survival in USC.MethodsWe conducted a retrospective review in women with USC managed at two large urban medical centers. Clinical and histopathologic parameters were retrieved. Recurrence and survival data were obtained from medical records and the Surveillance, Epidemiology, and End Results (SEER) registry. Differences in overall survival between African American and Caucasian women were compared using Kaplan–Meier curves and log rank test for univariate analysis. Cox regression models for multivariate analyses were built to evaluate the relative impact of the various prognostic factors.ResultsOne hundred seventy-two women with USC were included in this study, including 65 Caucasian women and 107 African American women. Both groups were similar with respect to age, stage at diagnosis, angiolymphatic invasion (p = 0.79), and the depth of myometrial invasion (p = 0.36). There was no statistical difference in overall survival between African American and Caucasian patients in univariate analysis (p = 0.14). In multivariate analysis, stage at diagnosis, angiolymphatic invasion, and depth of myometrial invasion, but not race, were significantly associated with overall survival.ConclusionIn this study, African American women with USC had a similar survival to Caucasian women. This suggests that the racial differences seen in USC at a larger population level may be diminished in hospital-based studies, where women are managed in a uniform way.

Research Highlights
► Overall survival was not statistically significant between the African American and Caucasian patients.
► In the multivariate analysis, angiolymphatic and myometrial invasions had a significant impact on prognosis in patients with stage I but not in those with higher stage disease (stage II-IV).
► Chemotherapy treatment had no impact on survival in patients with stage I disease, but was associated with improved survival in patients with stages II–IV tumors.