TY - JOUR
T1 - Race and risk of metastases and survival after radical prostatectomy
T2 - Results from the SEARCH database
AU - for the Shared Equal Access Regional Cancer Hospital (SEARCH) Database Study Group
AU - Freedland, Stephen J.
AU - Vidal, Adriana C.
AU - Howard, Lauren E.
AU - Terris, Martha K.
AU - Cooperberg, Matthew R.
AU - Amling, Christopher L.
AU - Kane, Christopher J.
AU - Aronson, William J.
N1 - Publisher Copyright:
© 2017 American Cancer Society
PY - 2017/11/1
Y1 - 2017/11/1
N2 - BACKGROUND: Black race is associated with prostate cancer (PC) diagnosis and poor outcome. Previously, the authors reported that black men undergoing radical prostatectomy (RP) in equal-access hospitals had an increased risk of biochemical disease recurrence (BCR), but recurrences were equally aggressive as those occurring in white men. The authors examined the association between race and long-term outcomes after RP. METHODS: Data regarding 1665 black men (37%) and 2791 white men (63%) undergoing RP were analyzed. Using Cox models, the authors tested the association between race and BCR, BCR with a prostate-specific antigen (PSA) doubling time <9 months (aggressive disease recurrence), metastases, PC-specific death, and overall death. RESULTS: At a median follow-up of 102 months, 1566 men (35%) developed BCR, 217 men (5%) experienced aggressive disease recurrence, 193 men (4%) developed metastases, and 1207 men (27%) had died, 107 of whom (2%) died of PC. White men were older and had a lower preoperative PSA level, a lower biopsy and pathological grade group, and more capsular penetration but less seminal vesicle invasion and positive surgical margins versus black men (all P<.05). Black men were found to have a more recent surgery year (P<.001). On univariable analysis, black race was associated with increased BCR (P =.003) and reduced overall death (P =.017). On multivariable analysis, black race was not found to be associated with BCR (hazard ratio [HR], 1.07; P =.26), aggressive recurrence (HR, 1.14; P =.42), metastasis (HR, 1.24; P =.21), PC-specific death (HR, 1.03; P =.91), or overall death (HR, 1.03; P =.67). CONCLUSIONS: Among men undergoing RP at equal-access centers, although black men were found to have an increased risk of BCR, they had similar risks of aggressive disease recurrence, metastasis, and PC-specific death compared with white men, and the risk of BCR was found to be similar after controlling for risk parameters. Longer follow-up is needed to confirm these findings. Cancer 2017;123:4199–4206.
AB - BACKGROUND: Black race is associated with prostate cancer (PC) diagnosis and poor outcome. Previously, the authors reported that black men undergoing radical prostatectomy (RP) in equal-access hospitals had an increased risk of biochemical disease recurrence (BCR), but recurrences were equally aggressive as those occurring in white men. The authors examined the association between race and long-term outcomes after RP. METHODS: Data regarding 1665 black men (37%) and 2791 white men (63%) undergoing RP were analyzed. Using Cox models, the authors tested the association between race and BCR, BCR with a prostate-specific antigen (PSA) doubling time <9 months (aggressive disease recurrence), metastases, PC-specific death, and overall death. RESULTS: At a median follow-up of 102 months, 1566 men (35%) developed BCR, 217 men (5%) experienced aggressive disease recurrence, 193 men (4%) developed metastases, and 1207 men (27%) had died, 107 of whom (2%) died of PC. White men were older and had a lower preoperative PSA level, a lower biopsy and pathological grade group, and more capsular penetration but less seminal vesicle invasion and positive surgical margins versus black men (all P<.05). Black men were found to have a more recent surgery year (P<.001). On univariable analysis, black race was associated with increased BCR (P =.003) and reduced overall death (P =.017). On multivariable analysis, black race was not found to be associated with BCR (hazard ratio [HR], 1.07; P =.26), aggressive recurrence (HR, 1.14; P =.42), metastasis (HR, 1.24; P =.21), PC-specific death (HR, 1.03; P =.91), or overall death (HR, 1.03; P =.67). CONCLUSIONS: Among men undergoing RP at equal-access centers, although black men were found to have an increased risk of BCR, they had similar risks of aggressive disease recurrence, metastasis, and PC-specific death compared with white men, and the risk of BCR was found to be similar after controlling for risk parameters. Longer follow-up is needed to confirm these findings. Cancer 2017;123:4199–4206.
KW - biochemical disease recurrence
KW - prostate cancer
KW - prostate cancer-specific death
KW - prostate-specific antigen doubling time (PSADT)
KW - race
KW - radical prostatectomy
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U2 - 10.1002/cncr.30834
DO - 10.1002/cncr.30834
M3 - Article
C2 - 28654204
AN - SCOPUS:85021350912
SN - 0008-543X
VL - 123
SP - 4199
EP - 4206
JO - Cancer
JF - Cancer
IS - 21
ER -
