Receipt of adjuvant endometrial cancer treatment according to race: an NRG Oncology/Gynecologic Oncology Group 210 Study

Felix, Ashley S.; Cohn, David E.; Brasky, Theodore M.; Zaino, Richard J.; Park, Kay J.; Mutch, David G.; Creasman, William T.; Thaker, Premal H.; Walker, Joan L.; Moore, Richard G.; Lele, Shashikant; Guntupalli, Saketh R.; Downs, Levi S.; Nagel, Christa; Boggess, John F.; Pearl, Michael L.; Ioffe, Olga B.; Randall, Marcus E.; Brinton, Louise A.

doi:10.1016/j.ajog.2018.08.002

Cited by 15 publications

(17 citation statements)

References 32 publications

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“…Our work extends that previous analysis by comparing, for the first time, rates of local and distant recurrence as well as PFS and DFS. The results from our meta-analysis are also consistent with several studies that, drawing on the US National Cancer Database, suggest better survival with ACR than AC [ 18 , 37 , 38 ]. In addition, we found evidence of better survival with ACR than AC specifically in patients with endometrial cancer in stage IIIC.…”

Section: Discussionsupporting

confidence: 91%

Recurrence and survival of patients with stage III endometrial cancer after radical surgery followed by adjuvant chemo- or chemoradiotherapy: a systematic review and meta-analysis

et al. 2023

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Objective To compare recurrence and survival in patients with stage III endometrial cancer after radical surgery, followed by either adjuvant chemoradiotherapy (ACR) or adjuvant chemotherapy (AC). Methods We searched for relevant studies in PubMed Central, Embase and the Cochrane Central Register of Controlled Trials. Data were pooled on rates of recurrence as well as rates of progression-free, disease-free and overall survival. Heterogeneity was evaluated using the I2 test. Subgroup and sensitivity analyses were performed to identify potential sources of heterogeneity. Results Data from 18,375 patients in 15 retrospective studies and one randomized controlled trial were meta-analyzed. Compared to the AC group, the ACR showed significantly lower risk of local recurrence (OR 0.43, 95%CI 0.32–0.59) and total recurrence (OR 0.72, 95%CI 0.58–0.89). ACR was also associated with significantly better overall survival (HR 0.66, 95%CI 0.57–0.76), progression-free survival (HR 0.56, 95%CI 0.39–0.81) and disease-free survival (HR 0.66, 95%CI 0.53–0.83). Conclusions Adding adjuvant radiotherapy to adjuvant chemotherapy after radical surgery may significantly reduce risk of local and overall recurrence, while significantly improving survival of patients with stage III endometrial cancer.

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Section: Discussionsupporting

confidence: 91%

Recurrence and survival of patients with stage III endometrial cancer after radical surgery followed by adjuvant chemo- or chemoradiotherapy: a systematic review and meta-analysis

et al. 2023

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“…12), reflecting the higher proportion of Black women diagnosed with nonendometrioid, high‐risk disease. When stratified by disease subtype, receipt of guideline‐concordant therapy in hospital‐based studies was lower among Black women than among White women for endometrioid subtypes, 183 but it was similar for nonendometrioid cancers 184,185 . However, population‐based studies of patients aged 65 years or older have reported that Black patients are more likely than White patients to have treatment delays and are less likely to receive adjuvant therapy regardless of histology 186,187 …”

Section: Selected Findingsmentioning

confidence: 99%

“…When stratified by disease subtype, receipt of guideline-concordant therapy in hospital-based studies was lower among Black women than among White women for endometrioid subtypes, 183 but it was similar for nonendometrioid cancers. 184,185 However, population-based studies of patients aged 65 years or older have reported that Black patients are more likely than White patients to have treatment delays and are less likely to receive adjuvant therapy regardless of histology. 186,187 Uterine corpus cancer is one of the few cancers for which survival has not substantially improved since the mid-1970s, reflecting few advances in treatment.…”

Section: Uterine Corpus (Endometrium)mentioning

confidence: 99%

Cancer treatment and survivorship statistics, 2022

Miller

Nogueira

Devasia

et al. 2022

CA A Cancer J Clinicians

1,890

1,089

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The number of cancer survivors continues to increase in the United States due to the growth and aging of the population as well as advances in early detection and treatment. To assist the public health community in better serving these individuals, the American Cancer Society and the National Cancer Institute collaborate triennially to estimate cancer prevalence in the United States using incidence and survival data from the Surveillance, Epidemiology, and End Results cancer registries, vital statistics from the Centers for Disease Control and Prevention's National Center for Health Statistics, and population projections from the US Census Bureau. Current treatment patterns based on information in the National Cancer Database are presented for the most prevalent cancer types by race, and cancer-related and treatment-related side-effects are also briefly described. More than 18 million Americans (8.3 million males and 9.7 million females) with a history of cancer were alive on January 1, 2022. The 3 most prevalent cancers are prostate (3,523,230), melanoma of the skin (760,640), and colon and rectum (726,450) among males and breast (4,055,770), uterine corpus (891,560), and thyroid (823,800) among females. More than one-half (53%) of survivors were diagnosed within the past 10 years, and two-thirds (67%) were aged 65 years or older. One of the largest racial disparities in treatment is for rectal cancer, for which 41% of Black patients with stage I disease receive proctectomy or proctocolectomy compared to 66% of White patients. Surgical receipt is also substantially lower among Black patients with non-small cell lung cancer, 49% for stages I-II and 16% for stage III versus 55% and 22% for White patients, respectively. These treatment disparities are exacerbated by the fact that Black patients continue to be less likely to be diagnosed with stage I disease than White patients for most cancers, with some of the largest disparities for female breast (53% vs 68%) and endometrial (59% vs 73%). Although there are a growing number of tools that can assist patients, caregivers, and clinicians in navigating the various phases of cancer survivorship, further evidence-based strategies and equitable access to available resources are needed to mitigate disparities for communities of color and optimize care for people with a history of cancer.

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“…The results from our meta-analysis are consistent with several previous studies. For example, analysis of data in the US National Cancer Data Base suggests better survival with ACR than AC [18,28,42] .…”

Section: Discussionmentioning

confidence: 99%

Recurrence and survival of patients with stage III endometrial cancer after radical surgery followed by adjuvant chemo- or chemoradiotherapy: a systematic review and meta-analysis

Cao

Fan

Zhang

et al. 2022

Preprint

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Objective To compare recurrence and survival in patients with stage III endometrial cancer after radical surgery, followed by either adjuvant chemoradiotherapy (ACR) or adjuvant chemotherapy (AC). Methods We searched for relevant studies in PubMed Central, Embase and the Cochrane Central Register of Controlled Trials. Data were pooled on rates of recurrence as well as rates of progression-free, disease-free and overall survival. Heterogeneity was evaluated using the I2 test. Subgroup and sensitivity analyses were performed to identify potential sources of heterogeneity. Results Data from 55,440 patients in 22 retrospective studies and one randomized controlled trial were meta-analyzed. Compared to the AC group, the ACR showed significantly lower risk of local recurrence (OR 0.43, 95%CI 0.31–0.58) and total recurrence (OR 0.71, 95%CI 0.58–0.87). ACR was also associated with significantly better overall survival (HR 0.68, 95%CI 0.63–0.74), progression-free survival (HR 0.54, 95%CI:0.38–0.77) and disease-free survival (HR 0.54, 95%CI 0.30–0.96). Conclusions Adding adjuvant radiotherapy to adjuvant chemotherapy after radical surgery may significantly reduce risk of local and overall recurrence, while significantly improving survival of patients with stage III endometrial cancer.

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Receipt of adjuvant endometrial cancer treatment according to race: an NRG Oncology/Gynecologic Oncology Group 210 Study

Abstract: Contrary to our hypothesis, we observed higher odds of specific adjuvant treatment regimens among black women as compared with white women within specific subgroups of endometrial cancer characteristics.

Cited by 15 publications

References 32 publications

Recurrence and survival of patients with stage III endometrial cancer after radical surgery followed by adjuvant chemo- or chemoradiotherapy: a systematic review and meta-analysis

Recurrence and survival of patients with stage III endometrial cancer after radical surgery followed by adjuvant chemo- or chemoradiotherapy: a systematic review and meta-analysis

Cancer treatment and survivorship statistics, 2022

Recurrence and survival of patients with stage III endometrial cancer after radical surgery followed by adjuvant chemo- or chemoradiotherapy: a systematic review and meta-analysis

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