Metastasis is a poor prognostic factor for endometrial cancer. Disparities between African-Americans and Caucasians in metastasis patterns require further investigation. Thus, this study aims to compare the patterns of metastasis between African-Americans (AA) and Caucasians (C) among different histological subtypes of endometrial cancer.
Data was extracted from Surveillance, Epidemiology, and End Results Program (SEER) database from 2010-2019. We extracted data of patients with endometroid, cyst, mixed cell adenocarcinoma and adenocarcinoma not otherwise specified who presented with metastasis to bone, brain, liver, or lung at the time of diagnosis. We calculated the relative risk (RR) and confidence interval (CI) using SPSS software, version 25.0 (IBM).
Compared to Caucasians, African-Americans had higher risk of lung and liver metastasis in all subtypes except cyst adenocarcinoma. Additionally, African-Americans with endometroid adenocarcinoma had higher risk of bone metastasis (RR=2.01, 95% CI 1.44-2.81, P>0.001). Lungs were the most prevalent site of metastasis in African-Americans and Caucasians across all subtypes. Adenocarcinoma not otherwise specified was the most common subtype associated with metastasis at the time of diagnosis.
| Cancer | Number of patients by race | AA compared to C. Metastasis site prevalence (%). Relative risk, 95% CI and p-value |
|---|---|---|
| Endometroid Adenocarcinoma | AA: 6382 C: 72807 | Bone: AA 40 (0.62%) C 228 (0.31%) – RR 2.01 – CI [1.44 to 2.81] P <0.001 Liver: AA 53 (0.83%) C 253 (0.34%) – RR 2.40 – CI [1.79 to 3.23] P <0.001 Lung: AA 104 (1.62%) C 652 (0.89%) – RR 1.83 – CI [1.49 to 2.25] P <0.001 |
| Mixed cell adenocarcinoma | AA: 733 C: 5468 | Liver: AA 17 (2.31%) C 49 (0.89%) – RR 2.59 – CI [1.50 to 4.48] P <0.001 Lung: AA 25 (3.41%) C 109 (1.99%) – RR 1.72 – CI [1.12 to 2.64] P =0.01 |
| Adenocarcinoma, NOS | AA: 641 C: 4176 | Liver: AA 42 (6.55%) C 112 (2.68%) – RR 2.51 – CI [1.77 to 3.54] P <0.001 Lung: AA 62 (9.67%) C 221 (5.29%) – RR 1.87 – CI [1.43 to 2.45] P <0.001 |
Across multiple subtypes of endometrial cancer, African-Americans are at increased risk of metastasis compared to Caucasians. Further studies of genetic and biological factors are warranted.