Urology Section, Surgery Department, Veterans Administration Caribbean Health Care System, San Juan, Puerto Rico; University of Puerto Rico, Medical Sciences Campus.
Department of Biostatistics and Bioinformatics, Duke Cancer Institute, Duke University School of Medicine, Durham, NC; Section of Urology, Division of Surgery, Durham VA Medical Center, Durham, North Carolina.
Urology. 2021 Mar;149:181-186. doi: 10.1016/j.urology.2020.10.043. Epub 2020 Nov 12.
To examine the associations between ethnicity and outcomes after radical prostatectomy (RP) among Hispanics. While non-Hispanic Black men have worse prostate cancer (PC) outcomes, there are limited data on outcomes of Hispanic men, especially after RP.
We identified 3789 White men who underwent RP between 1988 and 2017 in the Shared Equal Access Regional Cancer Hospital database. Men were categorized as Hispanic or non-Hispanic. Logistic regression was used to test the association between ethnicity and PC adverse features. Cox models were used to test the association between ethnicity and biochemical recurrence (BCR), metastases, and castration-resistant PC (CRPC). All models were adjusted for age, prostate-specific antigen, clinical stage, biopsy grade group, surgery year, and surgical center.
Of 3789 White men, 236 (6%) were Hispanic. Hispanic men had higher prostate-specific antigen, but all other characteristics were similar between ethnicities. On multivariable analysis, there was no difference between ethnicities in odds of extracapsular extension, seminal vesicle invasion, positive margins, positive lymph nodes, or high-grade disease (odds ratio 0.62-0.89, all P > .07). A total of 1168 men had BCR, 182 developed metastasis, and 132 developed CRPC. There was no significant association between Hispanic ethnicity and risk of BCR, metastases, or CRPC (hazards ratio 0.39-0.85, all P > .06).
In an equal access setting, we found no evidence Hispanic White men undergoing RP had worse outcomes than non-Hispanic White men. In fact, all hazard ratios were <1 and although they did not achieve statistical significance, suggest perhaps slightly better outcomes for Hispanic men. Larger studies are needed to confirm findings.
研究西班牙裔人群接受根治性前列腺切除术(RP)后的种族与结局之间的关联。虽然非裔黑人男性的前列腺癌(PC)结局较差,但有关西班牙裔男性结局的数据有限,尤其是在接受 RP 后。
我们在 Shared Equal Access Regional Cancer Hospital 数据库中确定了 1988 年至 2017 年间接受 RP 的 3789 名白人男性。男性分为西班牙裔或非西班牙裔。采用逻辑回归检验种族与 PC 不良特征之间的关联。采用 Cox 模型检验种族与生化复发(BCR)、转移和去势抵抗性 PC(CRPC)之间的关联。所有模型均根据年龄、前列腺特异性抗原、临床分期、活检分级组、手术年份和手术中心进行调整。
在 3789 名白人男性中,有 236 名(6%)为西班牙裔。西班牙裔男性的前列腺特异性抗原较高,但种族间其他特征相似。多变量分析显示,种族间包膜外延伸、精囊侵犯、阳性切缘、阳性淋巴结或高级别疾病的可能性无差异(比值比 0.62-0.89,所有 P>.07)。共有 1168 名男性发生 BCR,182 名发生转移,132 名发生 CRPC。西班牙裔种族与 BCR、转移或 CRPC 的风险无显著相关性(风险比 0.39-0.85,所有 P>.06)。
在平等获得治疗的环境中,我们没有发现接受 RP 的西班牙裔白人男性比非西班牙裔白人男性结局更差的证据。事实上,所有风险比均<1,尽管未达到统计学意义,但提示西班牙裔男性的结局可能稍好。需要更大的研究来证实这些发现。