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Racial differences in patients with adenocarcinoma of the endometrium
H S Cronjé1, S Fourie, M J Doman
1Gynecologic Oncology Group, University of the Orange Free State, Bloemfontein, South Africa.
Objective:
To determine the differences between white and black women with regard to the presentation and behavior of adenocarcinoma of the endometrium.
Method:
Records of 273 (68%) white patients and 117 (32%) black patients with endometrial adenocarcinoma were reviewed in Bloemfontein, South Africa. Survival data was calculated according to the direct method where losses in follow-up were regarded as tumor deaths.
Results:
Most patients (82%) were treated by pre-operative radium followed by total abdominal hysterectomy and bilateral salpingo-oophorectomy, with post-operative external irradiation where indicated. Pre-operatively, fewer black women had reached FIGO stage I, while a larger number had advanced to stages II-IV (P = 0.0024). In addition, the tumor differentiation was more often poor in the black group (P < 0.0001). Ten-year follow-up was achieved in 84% of the white patients and 51% of the black patients and the 10-year survival figures were 67% for white patients and 28% for blacks (P < 0.0001).
Conclusion:
Endometrial adenocarcinoma is a more aggressive disease in black women than it is in whites.
