Schlumbrecht Matthew, Bussies Parker, Huang Marilyn, Kobetz Erin, George Sophia
Division of Gynecologic Oncology, Sylvester Comprehensive Cancer center, University of Miami Miller School of Medicine, Miami, FL 33139, United States.
Department of Obstetrics, Gynecology, and Reproductive Science, University of Miami Miller School of Medicine, Miami, FL 33139, United States.
World J Clin Oncol. 2019 Oct 24;10(10):340-349. doi: 10.5306/wjco.v10.i10.340.
Black women are known to have a higher risk of aggressive endometrial cancers. Little data exist about the role of nativity as a determinant of survival outcomes in women with this disease.
Our objective was to evaluate a population of Haitian immigrants with endometrial cancer in an urban setting using the Florida Cancer Data System (FCDS).
A search of FCDS identified 107 women born in Haiti and who received treatment for invasive endometrial cancer in Miami-Dade County between 1989 and 2013. Clinicopathologic data were extracted to describe the cohort and assess associations with overall survival. Statistical analyses were performed using Cox proportional hazards models, the log-rank test, and the Kaplan-Meier method, with significance set at ≤ 0.05.
Median age at diagnosis was 65 years. 63.9% of the patients had a type II, high-grade, histology, and 52.6% presented with extrauterine metastatic disease. Nearly three quarters had health insurance. Within the entire cohort, only presence of extrauterine disease was associated with worse overall survival [Hazard ratio (HR) = 2.70, 95% confidence interval (CI): 1.31-5.57, = 0.007]. However, after stratification by histologic grade, both age (HR = 0.88, 95%CI: 0.81-0.96, = 0.002) and extrauterine disease (HR = 2.49, 95%CI: 1.01-6.21, = 0.049) were independently associated with worse survival, but only in women with type II malignancies.
Urban Haitian women with endometrial cancer have a high burden of aggressive histologies. Additional investigation to explain the etiology of these findings is needed.
众所周知，黑人女性患侵袭性子宫内膜癌的风险更高。关于出生地作为这种疾病女性生存结果决定因素的作用，现有数据很少。
我们的目标是使用佛罗里达癌症数据系统（FCDS）评估城市环境中患有子宫内膜癌的海地移民群体。
对FCDS进行检索，确定了1989年至2013年间出生于海地且在迈阿密 - 戴德县接受浸润性子宫内膜癌治疗的107名女性。提取临床病理数据以描述该队列并评估与总生存的关联。使用Cox比例风险模型、对数秩检验和Kaplan - Meier方法进行统计分析，显著性设定为≤0.05。
诊断时的中位年龄为65岁。63.9%的患者组织学类型为II型、高级别，52.6%的患者出现子宫外转移疾病。近四分之三的患者有医疗保险。在整个队列中，只有子宫外疾病的存在与较差的总生存相关[风险比（HR）= 2.70，95%置信区间（CI）：1.31 - 5.57，P = 0.007]。然而，按组织学分级分层后，年龄（HR = 0.88，95%CI：0.81 - 0.96，P = 0.002）和子宫外疾病（HR = 2.49，95%CI：1.01 - 6.21，P = 0.049）均与较差的生存独立相关，但仅在II型恶性肿瘤女性中如此。
城市海地子宫内膜癌女性具有侵袭性组织学的高负担。需要进一步调查以解释这些发现的病因。
