Combined adverse effect of African American race and deep stromal invasion on survival following radical hysterectomy for cervical cancer.
OBJECTIVE
The objective of the study was to explore the effect of African American race on survival following radical hysterectomy for cervical cancer.


METHODS
We reviewed all cases of stage IA-IIA cervical cancer treated with radical hysterectomy at our institution (1987-2001). Characteristics between races were compared using Mann Whitney U and chi(2) tests. Hazard ratios (HR) of survival were calculated using Cox regression.


RESULTS
We identified 134 Caucasian and 66 African American patients. There was a trend toward worse survival among African Americans (81.8% vs 88.8%, P = .165). An interaction effect between race and depth of stromal invasion was observed (P = .005), and the combination of African American race and deep stromal invasion had a powerful, independent effect on survival (HR of death 7.04 [95% confidence interval 2.48 to 19.94]).


CONCLUSIONS
The combination of African American race and deep stromal invasion has an adverse effect on survival following radical hysterectomy for cervical cancer and may warrant use of adjuvant therapy.
Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC 29425, USA.
Heidi
H
Sapp
Laura
L
Goetzl
William
W
Creasman
Matthew
M
Kohler
Paul
P
Underwood
Nestor
N
Esnaola
D000230:Adenocarcinoma / Q000208:ethnology / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000328:Adult; D001741:Black or African American; D001835:Body Weight; D002294:Carcinoma, Squamous Cell / Q000208:ethnology / Q000401:mortality / Q000473:pathology / Q000601:surgery; D015897:Comorbidity; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007044:Hysterectomy; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D017154:Stromal Cells / Q000473:pathology*; D016019:Survival Analysis; D002583:Uterine Cervical Neoplasms / Q000208:ethnology / Q000401:mortality* / Q000473:pathology* / Q000601:surgery