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. Study Design: 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 χ² 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]). Conclusion: 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.