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国家癌症数据库(NCDB)中转移性前列腺癌不存在种族生存差异:与非转移性疾病的不同发现

Lack of Racial Survival Differences in Metastatic Prostate Cancer in National Cancer Data Base (NCDB): A Different Finding Compared to Non-metastatic Disease.

作者信息

Vengaloor Thomas Toms, Gordy Xiaoshan Z, Lirette Seth T, Albert Ashley A, Gordy David P, Vijayakumar Srinivasan, Vijayakumar Vani

机构信息

Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS, United States.

Department of Health Sciences, University of Mississippi Medical Center, Jackson, MS, United States.

出版信息

Front Oncol. 2020 Sep 18;10:533070. doi: 10.3389/fonc.2020.533070. eCollection 2020.

Abstract

Inconsistent findings have been reported in the literature regarding racial differences in survival outcomes between African American and white patients with metastatic prostate cancer (mPCa). The current study utilized a national database to determine whether racial differences exist among the target population to address this inconsistency. This study retrospectively reviewed prostate cancer (PCa) patient data ( = 1,319,225) from the National Cancer Database (NCDB). The data were divided into three groupings based on the metastatic status: (1) no metastasis ( = 318,291), (2) bone metastasis ( = 29,639), and (3) metastases to locations other than bone, such as brain, liver, or lung ( = 952). Survival probabilities of African American and white PCa patients with bone metastasis were examined through parametric proportional hazards Weibull models and Bayesian survival analysis. These results were compared to patients with no metastasis or other types of metastases. No statistically supported racial disparities were observed for African American and white men with bone metastasis ( = 0.885). Similarly, there were no racial disparities in survival for those men suffering from other metastases (liver, lung, or brain). However, racial disparities in survival were observed among the two racial groups with non-metastatic PCa ( < 0.001) or when metastasis status was not taken into account ( < 0.001). The Bayesian analysis corroborates the finding. This research supports our previous findings and shows that there are no racial differences in survival outcomes between African American and white patients with mPCa. In contrast, racial disparities in the survival outcome continue to exist among non-metastatic PCa patients. Further research is warranted to explain this difference.

摘要

关于非裔美国人和白人转移性前列腺癌(mPCa)患者生存结果的种族差异,文献中报道的结果并不一致。本研究利用一个全国性数据库来确定目标人群中是否存在种族差异,以解决这一不一致性问题。本研究回顾性分析了来自国家癌症数据库(NCDB)的前列腺癌(PCa)患者数据(n = 1,319,225)。根据转移状态将数据分为三组:(1)无转移(n = 318,291),(2)骨转移(n = 29,639),以及(3)骨以外部位的转移,如脑、肝或肺(n = 952)。通过参数化比例风险威布尔模型和贝叶斯生存分析,研究了非裔美国人和白人骨转移PCa患者的生存概率。将这些结果与无转移或其他类型转移的患者进行比较。对于有骨转移的非裔美国人和白人男性,未观察到统计学支持的种族差异(P = 0.885)。同样,患有其他转移(肝、肺或脑)的男性在生存方面也没有种族差异。然而,在非转移性PCa的两个种族组之间(P < 0.001)或不考虑转移状态时(P < 0.001),观察到了生存方面的种族差异。贝叶斯分析证实了这一发现。本研究支持了我们之前的发现,并表明mPCa的非裔美国人和白人患者在生存结果上没有种族差异。相比之下,非转移性PCa患者在生存结果上的种族差异仍然存在。有必要进行进一步的研究来解释这种差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a161/7531281/f802ac77bb85/fonc-10-533070-g0001.jpg

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