Impact of Histology on Racial Disparities in Epithelial Ovarian Cancer Patients [39R

Abstract

INTRODUCTION: Epithelial ovarian cancer (EOC) is the most lethal gynecologic malignancy. Racial disparities between non-Hispanic white (NHW) and non-Hispanic black (NHB) patients with EOC has been documented, but data on the existence of disparities among other races is lacking. The objective of this study was to investigate the relationship between race, histology, and survival in EOC. METHODS: Data from women diagnosed with invasive EOC including serous, endometrioid, clear cell, and mucinous histology from 1990-2013 from the Surveillance, Epidemiology, and End Results (SEER) Program were used for analysis. RESULTS: A total of 68,206 patients were included. NHB patients had higher cancer-related mortality (CRM) than NHW patients in all histological classifications. Hispanic (HSP) and Asian Pacific Islander (API) patients had decreased risk of CRM for serous histology. API patients also had lower CRM for clear cell histology. Hazard ratio (HR) for NHB vs. NHW patients was the smallest in serous histology (HR 1.18, 95% Confidence Interval (CI) 1.12-1.26) and largest for mucinous histology (HR 1.54, 95% CI 1.34 -1.78). HSP (HR 0.91, 95% CI 0.87-0.96, P=0.0005) and API (HR 0.87, 95% CI 0.82-0.93, P<0.0001) patients had decreased risk of CRM for serous histology. API patients also had lower CRM for clear cell histology (HR 0.83, 95% CI 0.71-0.97, P<0.021). CONCLUSION: There are significant histologic differences among races. NHB patients have an increased risk for CRM in all histological subtypes. Recognizing these histological differences may allow for tailored therapy, which may reduce racial survival disparities observed in EOC.