Pd42-03 Pathologic and Biochemical Outcomes Among African-american and Caucasian Men With Low-risk Prostate Cancer in the Search Database: Implications for Active Surveillance Candidacy
Year: 2016
Type: article
Study design: Observational Study
Abstract: You have accessJournal of UrologyProstate Cancer: Staging I1 Apr 2016PD42-03 PATHOLOGIC AND BIOCHEMICAL OUTCOMES AMONG AFRICAN-AMERICAN AND CAUCASIAN MEN WITH LOW-RISK PROSTATE CANCER IN THE SEARCH DATABASE: IMPLICATIONS FOR ACTIVE SURVEILLANCE CANDIDACY Michael Leapman, Stephen Freedland, William Aaronson, Christopher Kane, Martha Terris, Kelly Walker, Christopher Amling, Peter Carroll, and Matthew Cooperberg Michael LeapmanMichael Leapman More articles by this author , Stephen FreedlandStephen Freedland More articles by this author , William AaronsonWilliam Aaronson More articles by this author , Christopher KaneChristopher Kane More articles by this author , Martha TerrisMartha Terris More articles by this author , Kelly WalkerKelly Walker More articles by this author , Christopher AmlingChristopher Amling More articles by this author , Peter CarrollPeter Carroll More articles by this author , and Matthew CooperbergMatthew Cooperberg More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1755AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Racial disparities in the incidence and risk profile of prostate cancer (PCa) at diagnosis among African-American (AA) men are well reported, however it remains unclear whether AA race is independently associated with adverse pathological findings among men with clinical low risk disease. METHODS We conducted a retrospective analysis among 895 men with clinical low risk (Gleason 3+3, clinical stage ≤T2a, PSA≤10 ng/mL) PCa treated with radical prostatectomy within the Shared Equal Access Regional Cancer Hospital (SEARCH) database. We evaluated baseline clinical and demographic characteristics stratified by AA or Caucasian race. Associations between AA versus Caucasian race with pathologic Gleason upgrade (≥3+4), major upgrade (≥4+3), upstage (pT3a or higher), positive margin status and biochemical recurrence were examined using chi-square, logistic regression, log-rank, and Cox proportional hazards analyses. RESULTS We identified 355 AA and 540 Caucasian men with low-risk tumors within the SEARCH cohort followed for a median of 6.3 years (IQR 3.8-8.9). AA men were younger (mean 59.5vs. 62.0 years, p<0.001), and had higher median PSA (5.5 vs. 5.1, p<0.001). Following adjustment for relevant covariates, AA race was not significantly associated with pathological upgrade (OR 1.34, 95% CI 0.94-1.91, p=0.111), major upgrade (OR 0.56, 95% CI 0.30-1.05, p=0.070), upstaging (OR 1.11, 95% CI 0.67-1.84, p=0.683), or positive surgical margins (OR 1.05, 95% CI 0.73-1.49, p=0.806). The 5-year recurrence-free survival rates were 73.4% and 78.4% for AA and Caucasian men, respectively (log-rank p=0.178). In a Cox proportional hazards analysis model, AA race was not significantly associated with BCR (HR 1.11, 95% CI 0.81-1.50, p=0.521). CONCLUSIONS In a cohort of low-risk men treated with prostatectomy within an equal access health system with a high representation of AA men, no significant differences were observed in the rates of pathologic upgrading, upstaging or biochemical recurrence. These data support continued use of AS in AA. Upgrading and upstaging remain concerning possibilities for all men regardless of race. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e987-e988 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Michael Leapman More articles by this author Stephen Freedland More articles by this author William Aaronson More articles by this author Christopher Kane More articles by this author Martha Terris More articles by this author Kelly Walker More articles by this author Christopher Amling More articles by this author Peter Carroll More articles by this author Matthew Cooperberg More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Source: The Journal of Urology
Institution: Carl von Ossietzky Universität Oldenburg
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4231361476