Originally published as JCO Early Release 10.1200/JCO.2005.02.1436 on December 19 2005

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Blackstock, A. W. Articles by Green, M. R. Search for Related Content PubMed PubMed Citation Articles by Blackstock, A. W. Articles by Green, M. R. Social Bookmarking                            What's this?

Similar Outcomes Between African American and Non–African American Patients With Extensive-Stage Small-Cell Lung Carcinoma: Report From the Cancer and Leukemia Group B

From the Wake Forest University School of Medicine, Winston-Salem; University of North Carolina at Chapel Hill, Chapel Hill; Cancer and Leukemia Group B Statistical Center, Duke University, Durham, NC; Ohio State University, Columbus OH; Dana Farber Cancer Institute, Boston MA; University of Tennessee–Memphis, Memphis TN; University of Chicago, Chicago IL; and Medical University of South Carolina, Charleston, SC

Address reprint requests to A. William Blackstock, MD, Department of Radiation Oncology, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157; e-mail: ablackst{at}wfubmc.edu

Purpose Among patients with small-cell lung carcinoma, African Americans have lower survival rates than non–African Americans. We investigated whether the disparity in survival would persist when patients were treated with similar therapies (ie, phase II/III Cancer and Leukemia Group B [CALGB] trials).

Patients and Methods We assessed 995 patients (928 non–African American and 67 African American) receiving chemotherapy in CALGB studies for extensive-stage small-cell lung cancer (ES-SCLC). Clinical and demographic characteristics, treatment received, and survival data were obtained from the CALGB database. The Cox proportional hazards model was used to assess the effect of race/ethnicity on survival after adjustment for other known prognostic factors. All statistical tests were two sided.

Results The unadjusted survival distribution of African American patients was not significantly different from that of non–African American patients; median survival was 11.5 months (95% CI, 9.4 to 13.4 months) for African American patients versus 9.9 months (95% CI, 9.6 to 10.3 months) for non–African American patients. Multivariable adjustment for the effect of treatment arm, histology, and metastatic site at presentation did not alter the outcome for African American patients. Survival was similar even though African American patients were more likely to have a poorer performance status, present with significant weight loss, and be Medicaid recipients (20% v 6%), which is an indicator of lower socioeconomic status.

Conclusion African American patients tended to present with prognostic features associated with a worse survival. However, when offered equivalent therapy, the outcome for African American patients was the same as that observed for non–African American patients.

Supported in part by Public Health Service Grant No. CA31946 from the National Cancer Institute (NCI), National Institutes of Health, Department of Health and Human Services, to the Cancer and Leukemia Group B (Richard L. Schilsky, MD, Chairman). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NCI.

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				E. T. Chang, S. J. Shema, H. A. Wakelee, C. A. Clarke, and S. L. Gomez Uncovering Disparities in Survival after Non-Small-Cell Lung Cancer among Asian/Pacific Islander Ethnic Populations in California Cancer Epidemiol. Biomarkers Prev., August 1, 2009; 18(8): 2248 - 2255. [Abstract] [Full Text] [PDF]

				J. E. Herndon II, A. B. Kornblith, J. C. Holland, and E. D. Paskett Patient Education Level As a Predictor of Survival In Lung Cancer Clinical Trials J. Clin. Oncol., September 1, 2008; 26(25): 4116 - 4123. [Abstract] [Full Text] [PDF]

				J. O. Park, S.-W. Kim, J. S. Ahn, C. Suh, J. S. Lee, J. S. Jang, E. K. Cho, S. H. Yang, J.-H. Choi, D. S. Heo, et al. Phase III Trial of Two Versus Four Additional Cycles in Patients Who Are Nonprogressive After Two Cycles of Platinum-Based Chemotherapy in Non Small-Cell Lung Cancer J. Clin. Oncol., November 20, 2007; 25(33): 5233 - 5239. [Abstract] [Full Text] [PDF]

				O. W. Brawley Lung Cancer and Race: Equal Treatment Yields Equal Outcome Among Equal Patients, but There Is No Equal Treatment J. Clin. Oncol., January 20, 2006; 24(3): 332 - 333. [Full Text] [PDF]