Abstract
Purpose Racial disparities in the incidence and risk profile of prostate cancer at diagnosis among African-American men are well reported. However, it remains unclear whether African-American race is independently associated with adverse outcomes in men with clinical low risk disease. Materials and Methods We retrospectively analyzed the records of 895 men in the SEARCH (Shared Equal Access Regional Cancer Hospital) database in whom clinical low risk prostate cancer was treated with radical prostatectomy. Associations of African-American and Caucasian race with pathological biochemical recurrence outcomes were examined using chi-square, logistic regression, log rank and Cox proportional hazards analyses. Results We identified 355 African-American and 540 Caucasian men with low risk tumors in the SEARCH cohort who were followed a median of 6.3 years. Following adjustment for relevant covariates African-American race was not significantly associated with pathological upgrading (OR 1.33, p = 0.12), major upgrading (OR 0.58, p = 0.10), up-staging (OR 1.09, p = 0.73) or positive surgical margins (OR 1.04, p = 0.81). Five-year recurrence-free survival rates were 73.4% in African-American men and 78.4% in Caucasian men (log rank p = 0.18). In a Cox proportional hazards analysis model African-American race was not significantly associated with biochemical recurrence (HR 1.11, p = 0.52). Conclusions In a cohort of patients at clinical low risk who were treated with prostatectomy in an equal access health system with a high representation of African-American men we observed no significant differences in the rates of pathological upgrading, up-staging or biochemical recurrence. These data support continued use of active surveillance in African-American men. Upgrading and up-staging remain concerning possibilities for all men regardless of race.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1408-1414 |
| Number of pages | 7 |
| Journal | Journal of Urology |
| Volume | 196 |
| Issue number | 5 |
| DOIs | |
| State | Published - Nov 1 2016 |
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Keywords
- African Americans
- neoplasm grading
- neoplasm staging
- prostatic neoplasms
- watchful waiting
ASJC Scopus subject areas
- Urology
Cite this
Pathological and Biochemical Outcomes among African-American and Caucasian Men with Low Risk Prostate Cancer in the SEARCH Database : Implications for Active Surveillance Candidacy. / Leapman, Michael S.; Freedland, Stephen J.; Aronson, William J.; Kane, Christopher J.; Terris, Martha K.; Walker, Kelly; Amling, Christopher; Carroll, Peter R.; Cooperberg, Matthew R.
In: Journal of Urology, Vol. 196, No. 5, 01.11.2016, p. 1408-1414.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Pathological and Biochemical Outcomes among African-American and Caucasian Men with Low Risk Prostate Cancer in the SEARCH Database
T2 - Implications for Active Surveillance Candidacy
AU - Leapman, Michael S.
AU - Freedland, Stephen J.
AU - Aronson, William J.
AU - Kane, Christopher J.
AU - Terris, Martha K.
AU - Walker, Kelly
AU - Amling, Christopher
AU - Carroll, Peter R.
AU - Cooperberg, Matthew R.
PY - 2016/11/1
Y1 - 2016/11/1
N2 - Purpose Racial disparities in the incidence and risk profile of prostate cancer at diagnosis among African-American men are well reported. However, it remains unclear whether African-American race is independently associated with adverse outcomes in men with clinical low risk disease. Materials and Methods We retrospectively analyzed the records of 895 men in the SEARCH (Shared Equal Access Regional Cancer Hospital) database in whom clinical low risk prostate cancer was treated with radical prostatectomy. Associations of African-American and Caucasian race with pathological biochemical recurrence outcomes were examined using chi-square, logistic regression, log rank and Cox proportional hazards analyses. Results We identified 355 African-American and 540 Caucasian men with low risk tumors in the SEARCH cohort who were followed a median of 6.3 years. Following adjustment for relevant covariates African-American race was not significantly associated with pathological upgrading (OR 1.33, p = 0.12), major upgrading (OR 0.58, p = 0.10), up-staging (OR 1.09, p = 0.73) or positive surgical margins (OR 1.04, p = 0.81). Five-year recurrence-free survival rates were 73.4% in African-American men and 78.4% in Caucasian men (log rank p = 0.18). In a Cox proportional hazards analysis model African-American race was not significantly associated with biochemical recurrence (HR 1.11, p = 0.52). Conclusions In a cohort of patients at clinical low risk who were treated with prostatectomy in an equal access health system with a high representation of African-American men we observed no significant differences in the rates of pathological upgrading, up-staging or biochemical recurrence. These data support continued use of active surveillance in African-American men. Upgrading and up-staging remain concerning possibilities for all men regardless of race.
AB - Purpose Racial disparities in the incidence and risk profile of prostate cancer at diagnosis among African-American men are well reported. However, it remains unclear whether African-American race is independently associated with adverse outcomes in men with clinical low risk disease. Materials and Methods We retrospectively analyzed the records of 895 men in the SEARCH (Shared Equal Access Regional Cancer Hospital) database in whom clinical low risk prostate cancer was treated with radical prostatectomy. Associations of African-American and Caucasian race with pathological biochemical recurrence outcomes were examined using chi-square, logistic regression, log rank and Cox proportional hazards analyses. Results We identified 355 African-American and 540 Caucasian men with low risk tumors in the SEARCH cohort who were followed a median of 6.3 years. Following adjustment for relevant covariates African-American race was not significantly associated with pathological upgrading (OR 1.33, p = 0.12), major upgrading (OR 0.58, p = 0.10), up-staging (OR 1.09, p = 0.73) or positive surgical margins (OR 1.04, p = 0.81). Five-year recurrence-free survival rates were 73.4% in African-American men and 78.4% in Caucasian men (log rank p = 0.18). In a Cox proportional hazards analysis model African-American race was not significantly associated with biochemical recurrence (HR 1.11, p = 0.52). Conclusions In a cohort of patients at clinical low risk who were treated with prostatectomy in an equal access health system with a high representation of African-American men we observed no significant differences in the rates of pathological upgrading, up-staging or biochemical recurrence. These data support continued use of active surveillance in African-American men. Upgrading and up-staging remain concerning possibilities for all men regardless of race.
KW - African Americans
KW - neoplasm grading
KW - neoplasm staging
KW - prostatic neoplasms
KW - watchful waiting
UR - http://www.scopus.com/inward/record.url?scp=84992341733&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84992341733&partnerID=8YFLogxK
U2 - 10.1016/j.juro.2016.06.086
DO - 10.1016/j.juro.2016.06.086
M3 - Article
C2 - 27352635
AN - SCOPUS:84992341733
VL - 196
SP - 1408
EP - 1414
JO - Journal of Urology
JF - Journal of Urology
SN - 0022-5347
IS - 5
ER -