Type II endometrial cancer in Hispanic women: Tumor characteristics,treatment and survival compared to non-Hispanic white women

Objectives

To compare survival of Hispanic white (HW) and non-Hispanic white (NHW) women with type II endometrial adenocarcinoma (EC).

Methods

Patients with serous, clear cell or grade 3 endometrioid EC were identified from the Surveillance, Epidemiology, and End Results (SEER) program 1988–2009 and were divided into HW and NHW. HW were subdivided into natives and immigrants.

Results

Of the 14,434 women, 13,012 (90.2%) were NHW and 1422 (9.8%) were HW. HW were younger than NHW (mean 63 vs. 68 years, p < 0.001). A higher proportion of HW presented with late stage disease than NHW (43.8% vs. 36.6%, p = 0.04). Performing lymphadenectomy was not different but HW were more likely to have positive lymph nodes than NHW (27.6% vs. 23.1%, p = 0.02). Further, HW were less likely to receive radiation than NHW (39.5% vs. 42.3%, p = 0.04). No difference in clinicopathologic characteristics was found between immigrant and native HW. In multivariate models adjusting for age, stage, histology, surgical treatment, extent of lymphadenectomy, and radiation therapy, no difference in overall survival (OS) (HR 1.06, 95% CI 0.97–1.16, p = 0.19) and cancer-specific survival (CSS) (HR 1.02, 95% CI 0.91–1.14, p = 0.75) was found between HW and NHW. Interestingly, immigrant HW had better OS (HR 0.74, 95% CI 0.62–0.89, p < 0.001) and CSS (HR 0.72, 95% CI 0.58–0.90, P = 0.003) than native HW.

Conclusions

Although they were more likely to present with advanced stage and positive nodal disease, no difference in outcome was noted between Hispanic and non-Hispanic whites with EC. Interestingly, immigrant HW had more favorable outcome compared to native HW.