Resnick M J, Canter D J, Guzzo T J, Brucker B M, Bergey M, Sonnad S S, Wein A J, Malkowicz S B
Division of Urology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA.
Urology. 2009 Mar;73(3):620-3. doi: 10.1016/j.urology.2008.09.035. Epub 2008 Dec 18.
To assess the magnitude of racial disparities in prostate cancer outcomes following radical prostatectomy for low-risk prostate cancer.
We retrospectively reviewed our database of 2407 patients who under went radical prostatectomy and isolated 2 cohorts of patients with low-risk prostate cancer. Cohort 1 was defined using liberal criteria, and cohort 2 was isolated using more stringent criteria. We then studied pre- and postoperative parameters to discern any racial differences in these 2 groups. Statistical analyses, including log-rank, chi(2), and Fisher's exact analyses, were used to ascertain the significance of such differences.
Preoperatively, no significant differences were found between the white and African-American patients with regard to age at diagnosis, mean prostate-specific antigen, median follow-up, or percentage of involved cores on prostate biopsy. African-American patients in cohort 1 had a greater mean body mass index than did white patients (26.9 vs 27.8, P = .026). The analysis of postoperative data demonstrated no significant difference between white and African-American patients in the risk of biochemical failure, extraprostatic extension, seminal vesicle involvement, positive surgical margins, tumor volume, or risk of disease upgrading. African-American patients in cohort 2 demonstrated greater all-cause mortality compared with their white counterparts (9.4% vs 3.1%, P = .027).
In patients with low-risk prostate cancer treated with radical prostatectomy, there exist no significant differences in surrogate measures of disease control, risk of disease upgrading, estimated tumor volume, or recurrence-free survival between whites and African-Americans.
评估低危前列腺癌根治性前列腺切除术后种族差异在前列腺癌预后中的程度。
我们回顾性分析了2407例行根治性前列腺切除术患者的数据库，并分离出2组低危前列腺癌患者。队列1采用宽松标准定义，队列2采用更严格标准分离。然后我们研究术前和术后参数，以辨别这2组中的任何种族差异。采用包括对数秩检验、卡方检验和Fisher精确检验在内的统计分析来确定这些差异的显著性。
术前，白人和非裔美国患者在诊断年龄、平均前列腺特异性抗原、中位随访时间或前列腺活检中受累核心的百分比方面未发现显著差异。队列1中的非裔美国患者平均体重指数高于白人患者（26.9对27.8，P = 0.026）。术后数据分析表明，白人和非裔美国患者在生化失败风险、前列腺外扩展、精囊受累、手术切缘阳性、肿瘤体积或疾病升级风险方面无显著差异。队列2中的非裔美国患者与白人患者相比，全因死亡率更高（9.4%对3.1%，P = 0.027）。
在接受根治性前列腺切除术治疗的低危前列腺癌患者中，白人和非裔美国人在疾病控制替代指标、疾病升级风险、估计肿瘤体积或无复发生存率方面没有显著差异。
