Prognosis after XXXX in blacks and whites participating in adjuvant therapy randomized trials.

@entity5 @entity1 @entity14
PURPOSE: National health statistics indicate that blacks have lower survival rates from @entity14 than do whites. This disparity has been attributed to differences in stage at diagnosis and other disease features, extent and quality of treatment, and socioeconomic factors. We evaluated outcomes for blacks and whites with @entity5 who participated in randomized clinical trials of the National Surgical Adjuvant Breast and Bowel Project (NSABP). The randomized trial setting enhances uniformity in disease stage and treatment plan among all @entity1 . @entity1 AND METHODS: The study included black (N = 104) or white (N = 1,070) @entity1 from two serially conducted NSABP randomized trials for operable @entity5 . Recurrence-free survival and survival were compared using statistical modeling to account for differences in @entity1 and disease characteristics between the groups. RESULTS: Blacks and whites had largely similar disease features at diagnosis. After adjustment for @entity1 and @entity5 prognostic covariates, the black/white recurrence hazard ratio (HR) was 1.25 (95% confidence interval [CI], 0.94 to 1.66). The mortality HR was somewhat larger at 1.45 (95% CI = 1.09 to 1.93). Outcomes were improved for both groups in the more recent trial, which employed systemic adjuvant chemotherapy in all treatment arms. CONCLUSION: Recurrence-free survival was modestly less favorable for blacks, whereas overall survival was more disparate. Outcomes between groups were more comparable than those noted in national health statistics surveys and other studies. Adequate treatment access and the identification of new prognostic factors that can identify @entity1 at high risk of recurrence are needed to ensure optimal outcomes for @entity5 @entity1 of all racial/ethnic backgrounds.
