Diversities and disparities in endometrial carcinoma (EC): Clinical pathological features and outcomes from indigenous populations—A French multicentric retrospective study.

Abstract

e13803 Background: Disparities in cancer care access remain significant. Cancer epidemiology in French overseas territories (FOT) differs from mainland France (FRANCIM 2019). Indigenous populations are underrepresented in clinical trials, and their outcomes are poorly studied. This study reports clinicopathological features and outcomes of EC patients from five FOT: Martinique, Guadeloupe (French West Indies), French Polynesia (FP), Wallis and Futuna (WF), and Reunion Island. Methods: We conducted a multicenter retrospective study of EC patients treated in these territories. Results: We included 1,040 patients. Three distinct groups emerged, corresponding to specific geographical areas. Patients from FP and WF were younger and predominantly obese compared to mainland France. Endometrioid histology was most common, diagnosed early. Nearly 45% of FWI patients had non-endometrioid subtypes and were diagnosed at advanced stages. Patients from Reunion showed similarities to mainland Caucasians (Table 1). The 5-year OS rate was 60.8% (95% CI: 54.2–68.2) in FP, 76.4% (95% CI: 61.9–94.2) in WF, and 55% (95% CI: 42–60.3) in Martinique. In Reunion, the 3-year OS rate was 70.8% (95% CI: 62.2–77.8); 5-year OS data and Guadeloupe data were unavailable. Conclusions: The FOT face unique challenges in managing endometrial cancer. Overall survival rates are lower than mainland France. These populations are underrepresented in research, and mainland guidelines are often applied despite distinct characteristics. Further studies are needed to develop tailored strategies and reduce disparities. Patients and tumor characteristics. Endometrial carcinomaFrench Polynesia Endometrial carcinomaWallis and Futuna Endometrial carcinomaMartinique Endometrial carcinomaGuadeloupe Endometrial carcinomaLa Reunion N 372 43 213 140 272 Age at diagnosis Median (IQR) 58 (20 – 88) 56 (47-65.5) 70 (32-95) 71 (46-95) 63.5 (31-94) Mean BMI BMI ≥ 30 in patients 34.643.4% 37.487.8% 31.149.3 % NA NA FIGO stage at diagnosisStage IStage IIStage IIIStage IVMissing 193 (51.7%)25 (6.5%)45 (12.1%)54 (14.5%)55 (15%) 35 (81.4%)1 (2.3%)4 (9.3%)1 (2.3%)2 (4.7%) 104 (48.8%)13 (6.1%)42 (19,7%)48 (22.5%)6 (2.8%) 51 (36,4 %)8 (5,7 %)29 (20,7 %)31 (22,1 %)21 (15%) 185 (68 %) 7 (2.6%)39 (14.3%)33 (12.1%)8 (2.9%) HistologyEndometrioïd Serous adenocarcinomaClear cell adenocarcinomaMixed tumorCarcinosarcomaOthersMissing/Unclassifiable 297(79.8%)21 (5.6%)9 (2.4%)00045(12%) 38(88.4%)3(7.0%)1(2.3%)0001(2.3%) 112 (52.6 %)53 (24.9%)4 (1.9%)6 (2.8%)32 (15%)1 (0,5%)5 (2.3%) 75 (53.6 %)41 (29.3 %)1 (0.7 %)2 (1,4 %)15 (10.7 %)3 (2.1 %)3 (2.1 %) 208 (76.5%)32 (11.7%)7 (2.7%)017 (6.1%)08 (2.9%)