Format

Send to

Choose Destination
Gynecol Oncol. 2014 Apr;133(1):38-42. doi: 10.1016/j.ygyno.2014.01.013.

Endometrial cancer in morbidly obese women: do racial disparities affect surgical or survival outcomes?

Author information

1
Wayne State University School of Medicine, Department of Oncology, Detroit, MI, USA; Karmanos Cancer Institute, Population Studies and Disparities Program, Detroit, MI, USA. Electronic address: cotem@karmanos.org.
2
Wayne State University School of Medicine, Department of Oncology, Detroit, MI, USA.
3
Wayne State University School of Medicine, Department of Pathology, Detroit, MI, USA.
4
Wayne State University School of Medicine, Department of Gynecologic Oncology, Detroit, MI, USA; Karmanos Cancer Institute, Department of Gynecologic Oncology, Detroit, MI, USA.

Abstract

OBJECTIVE:

Endometrial cancer mortality disproportionately affects black women and whether greater prevalence of obesity plays a role in this disparity is unknown. We examine the effect of race on post-surgical complications, length of stay, and mortality specifically in a morbidly obese population.

METHODS:

Black and white women with endometrial cancer diagnosed from 1996 to 2012 were identified from the University Pathology Group database in Detroit, Michigan, and records were retrospectively reviewed to obtain clinicopathological, demographic, and surgical information. Analysis was limited to those with a body mass index of 40kg/m(2) or greater. Differences in the distribution of variables by race were assessed by chi-squared tests and t-tests. Kaplan-Meier and Cox regression analyses were performed to examine factors associated with mortality.

RESULTS:

97 white and 89 black morbidly obese women were included in this analysis. Black women were more likely to have type II tumors (33.7% versus 15.5% of white women, p-value=0.003). Hypertension was more prevalent in black women (76.4% versus 58.8%, p-value=0.009), and they had longer hospital stays after surgery despite similar rates of open vs minimally invasive procedures and lymph node dissection (mean days=5.4) compared to whites (mean days=3.5, p-value=0.036). Wound infection was the most common complication (16.5% in whites and 14.4% in blacks, p-value=0.888). Blacks were more likely to suffer other complications, but overall the proportions did not differ by race. In univariate analyses, black women had higher risk of endometrial cancer-related death (p-value=0.090). No racial differences were noted in adjusted survival analyses.

CONCLUSION:

A more complete investigation, incorporating socio-demographic factors, is warranted to understand the effects of morbid obesity and race on endometrial cancer.

KEYWORDS:

Endometrial carcinoma; Morbid obesity; Race/ethnicity

PMID:
24680590
PMCID:
PMC4170855
DOI:
10.1016/j.ygyno.2014.01.013
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center