Guideline-concordant treatment is associated with improved survival among women with non-endometrioid endometrial cancer

Dholakia, Jhalak; Llamocca, Elyse; Quick, Allison; Salani, Ritu; Felix, Ashley S.

doi:10.1016/j.ygyno.2020.03.016

Cited by 19 publications

(20 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These patterns should be further examined with larger samples of AI/AN women. Patterns for Asian women supported findings from other studies that have found similar or better survival for Asian women compared with White women 30,31,36 . However, our study was the first that we are aware of to observe that NHPI women have a poorer survival rate compared with White women.…”

Section: Discussionsupporting

confidence: 87%

“…Our finding that Black women were less likely to receive adherent care and experienced decreased survival compared with White women is a common finding within various cancer sites 5,6,30 . However, findings from a study that examined NCCN adherence among White, Black, Latina, and Asian/Pacific Islander women with nonendometrioid endometrial carcinomas did not find any racial/ethnic disparities in treatment 31 . Another study on endometrial cancer found that racial disparities persisted between Black and White women even when they received similar chemotherapy intensity and dosage, indicating that other factors may influence these disparities 32 .…”

Section: Discussionmentioning

confidence: 62%

“…Additionally, Black and NHPI women had worse survival compared with White women, whereas Asian women had improved survival compared with White women. The literature indicates that Black women are more likely to have an advanced stage at diagnosis and more aggressive tumors than other racial/ethnic groups, which could shape differences observed in overall survival 1,2,9,15,30,31,32,33 . Although our review of the literature did not identify any studies specific to NHPI women, few noted Asian/Pacific Islander women having higher grade tumors and less favorable histologic types compared with White women 15,33,34 .…”

Section: Discussionmentioning

confidence: 86%

See 2 more Smart Citations

Guideline‐adherent treatment, sociodemographic disparities, and cause‐specific survival for endometrial carcinomas

Rodríguez

LeBrón

Chang

et al. 2021

Cancer

View full text Add to dashboard Cite

BACKGROUND Adherence to National Comprehensive Cancer Network guidelines have been adopted as the standard of care for various cancers and have been cited to have survival benefits. Few studies have examined the association of adherent treatment and endometrial cancer survival among various racial/ethnic groups and socioeconomic statuses. METHODS Between January 1, 2006 and December 31, 2015, 83,673 women diagnosed with endometrial carcinomas were identified from the Surveillance, Epidemiology, and End Results database. Descriptive statistics of demographic and clinical characteristics were performed. Cox‐proportional hazards models were used to examine the effect on cause‐specific survival for adherence to guidelines across racial/ethnic and socioeconomic groups. RESULTS Within our sample, 59.5% were treated according to guidelines. Nonadherence to treatment guidelines was significantly associated with decreased survival compared with adherent care (adjusted hazard ratio [HR], 1.59; 95% CI, 1.52‐1.67). Being of Black (adjusted HR, 1.41; 95% CI, 1.32‐1.51) or Native Hawaiian/Pacific Islander (adjusted HR, 1.44; 95% CI, 1.19‐1.73) race/ethnicity compared with White women was significantly associated with worse survival. Being of Asian race/ethnicity (adjusted HR, 0.86, 95% CI, 0.78‐0.94) was significantly associated with improved survival compared with White women. Lower neighborhood socioeconomic status was associated with a negative effect on survival relative to women in the highest socioeconomic status category. CONCLUSIONS Findings from this study suggest treatment adherence is an independent predictor of improved survival; however, improved survival was not observed equally among all racial/ethnic and socioeconomic status groups. LAY SUMMARY The National Comprehensive Cancer Network (NCCN) has developed guidelines for physicians to follow in treating various cancers. Within this study of 83,673 women with endometrial cancer, 59.5% of women were treated according to the NCCN guidelines. The findings suggest following NCCN guidelines for treatment of endometrial cancer improves survival. Black or Native Hawaiian/Pacific Islander race and lower neighborhood socioeconomic status has worse survival rates compared with other groups, indicating the importance of exploring other factors that may shape treatment across racial/ethnic and socioeconomic status groups.

show abstract

Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 86%

See 1 more Smart Citation

Guideline‐adherent treatment, sociodemographic disparities, and cause‐specific survival for endometrial carcinomas

Rodríguez

LeBrón

Chang

et al. 2021

Cancer

View full text Add to dashboard Cite

show abstract

“…Further meta‐analyses also justified the adoption of MIS in endometrial cancer patients 18–20 . Based on these studies, MIS is recommended in the surgical management of low‐ and intermediate‐risk endometrial cancer by many clinical practice guidelines 9,21–23 …”

Section: Discussionmentioning

confidence: 99%

Oncologic safety of laparoscopic surgery for women with apparent early‐stage uterine serous carcinoma: A multi‐institutional retrospective cohort study

Shen

Zhang

et al. 2021

Intl J Gynecology & Obste

View full text Add to dashboard Cite

Cancer of the endometrium is the most common malignancy of the female reproductive system in developed countries, its incidence and associated mortality are increasing because rates of obesity have risen. [1][2][3] Two broad histologic types of endometrial cancer were proposed by Bokhman in 1983. 4 Type I tumors, affecting about 80% of cases, are mediated primarily by hyperestrogenism and are generally associated with a good prognosis. 2,5 Type II endometrial cancers, in contrast, have no exact pathogenesis. 2,5 Histologically, type II tumors are poorly differentiated or undifferentiated, most commonly serous and clear cell subtypes. 6 They are clinically aggressive, usually present at advanced stages, are associated with poor prognosis, and have a higher risk of recurrence. 6,7 Uterine serous carcinoma (USC) is the most common histologic type of type II endometrial cancer, accounting for about 80% of non-endometrioid endometrial cancer and approximately 40% of all endometrial cancer-related mortality. 8

show abstract

“…Previous studies have also shown that non-White women are less likely to receive National Comprehensive Cancer Network (NCCN) guideline concordant treatment for endometrial cancer. Black women diagnosed with endometrial cancer have been shown to have worse survival rates on a stage for stage basis as well as across histologic subtypes compared to White women ( Kaspers et al, 2020 , Horne et al, 2020 , Huang et al, 2020 , Dholakia et al, 2020 ). Many studies have shown these disparities in outcomes; however, these studies included heterogeneously treated women and were unable to differentiate cancer-specific survival.…”

Section: Introductionmentioning

confidence: 99%

Disparities in cancer-specific and overall survival in black women with endometrial cancer: A Medicare-SEER study

Saris

Smith

Brensinger

et al. 2022

Gynecologic Oncology Reports

View full text Add to dashboard Cite

Guideline-concordant treatment is associated with improved survival among women with non-endometrioid endometrial cancer

Cited by 19 publications

References 21 publications

Guideline‐adherent treatment, sociodemographic disparities, and cause‐specific survival for endometrial carcinomas

Guideline‐adherent treatment, sociodemographic disparities, and cause‐specific survival for endometrial carcinomas

Oncologic safety of laparoscopic surgery for women with apparent early‐stage uterine serous carcinoma: A multi‐institutional retrospective cohort study

Disparities in cancer-specific and overall survival in black women with endometrial cancer: A Medicare-SEER study

Contact Info

Product

Resources

About