Department of Urology, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR, 72205, USA.
Department of Urology, Ain Shams University, Cairo, Egypt.
Int Urol Nephrol. 2019 Apr;51(4):561-569. doi: 10.1007/s11255-019-02116-2. Epub 2019 Mar 6.
To study regional trends in average years of potential life lost (AYPLL) among Caucasians (CA) and African Americans (AA) with prostate cancer (Pca) who received radical prostatectomy or radiation therapy among four different regions in the US as well as across different tumor grades. Years of potential life lost is defined as the difference between a predetermined end-point age and the age at death for a death that occurred prior to that end age, hence the AYPLL is calculated by dividing the total YPLL by the total number of patients died.
The surveillance epidemiology and end results (SEER) database was used to identify Pca patients who were CA or AA and who have received radical prostatectomy or radiation therapy. Study duration was divided into four decades; 1973-1982 (D1), 1983-1992 (D2), 1993-2002 (D3), 2003-2012 (D4). Examined regions were; North East (NE), North central (NC), South and West. Tumor grade was classified into; well/moderately differentiated (WD/MD) and poorly/undifferentiated (PD/UD) groups. Differences in AYPLL among CA and AA in each of these variables were compared.
Overall, compared to CA, AA were diagnosed and died earlier from Pca. AA had higher AYPLL to Pca than CA. In both tumor grade groups, progressive increase in AYPLL among AA compared to CA was noted over the last three decades. In the WD/MD group, except for the South region, the highest recorded difference in AYPLL between AA and CA was in D4. In the PD/UD group, a similar difference in AYPLL between AA and CA was noted in all regions. The difference in AYPLL was higher in the PD/UD group than the WD/MD group.
Racial disparity between AA and CA existed across the examined regions. It is more pronounced in advanced tumor grades. The differences were more significant in the last decade.
研究美国四个不同地区和不同肿瘤分级中接受根治性前列腺切除术或放射治疗的白种人（CA）和非裔美国人（AA）前列腺癌（Pca）患者的平均预期寿命损失年数（AYPLL）的区域趋势。预期寿命损失年数的定义为预定终点年龄与死亡年龄之间的差异，死亡发生在该终点年龄之前，因此 AYPLL 通过将总 YPLL 除以死亡患者总数来计算。
使用监测、流行病学和最终结果（SEER）数据库来确定接受根治性前列腺切除术或放射治疗的 CA 或 AA 前列腺癌患者。研究时间分为四个十年；1973-1982 年（D1）、1983-1992 年（D2）、1993-2002 年（D3）、2003-2012 年（D4）。检查的区域为；东北部（NE）、中北部（NC）、南部和西部。肿瘤分级分为；高分化/中分化（WD/MD）和低分化/未分化（PD/UD）组。比较了这些变量中 CA 和 AA 之间 AYPLL 的差异。
总体而言，与 CA 相比，AA 从 Pca 被诊断和死亡更早。AA 比 CA 有更高的 Pca AYPLL。在这两个肿瘤分级组中，在过去的三十年中，AA 比 CA 的 AYPLL 逐渐增加。在 WD/MD 组中，除了南部地区外，在 D4 中记录到 AA 和 CA 之间 AYPLL 的最大差异。在 PD/UD 组中，在所有地区都注意到 AA 和 CA 之间 AYPLL 的相似差异。PD/UD 组的 AYPLL 差异高于 WD/MD 组。
在检查的区域中，AA 和 CA 之间存在种族差异。在晚期肿瘤分级中更为明显。在过去十年中，差异更为显著。
