Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada.
Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, IRCCS Ospedale San Raffaele, Università Vita-Salute San Raffaele, Via Olgettina 60, 20132, Milan, Italy.
World J Urol. 2022 Jan;40(1):103-110. doi: 10.1007/s00345-021-03816-0. Epub 2021 Aug 26.
Race/ethnicity may predispose to less favorable prostate cancer characteristics in intermediate risk prostate cancer (IR PCa) patients. We tested this hypothesis in a subgroup of IR PCa patients treated with radical prostatectomy (RP).
We relied on the Surveillance, Epidemiology and End Results 2004-2016. The effect of race/ethnicity was tested in univariable and multivariable logistic regression analyses predicting upstaging (pT3+/pN1) and/or upgrading (Gleason Grade Group [GGG] 4-5) at RP.
Of 20,391 IR PCa patients, 15,050 (73.8%) were Caucasian, 2857 (14.0%) African-American, 1632 (8.0%) Hispanic/Latino and 852 (4.2%) Asian. Asian patients exhibited highest age (64 year), highest PSA (6.8 ng/ml) and highest rate of GGG3 (31.9%). African-Americans exhibited the highest percentage of positive cores at biopsy (41.7%) and the highest proportion of NCCN unfavorable risk group membership (54.6%). Conversely, Caucasians exhibited the highest proportion of cT2 stage (35.6%). In univariable analyses, Hispanic/Latinos exhibited the highest rates of upstaging/upgrading among all race/ethnicities, in both favorable and unfavorable groups, followed by Asians, Caucasians and African-Americans in that order. In multivariable analyses, Hispanic/Latino race/ethnicity represented an independent predictor of higher upstaging and/or upgrading in favorable IR PCa (odds ratio [OR] 1.27, p < 0.01), while African-American race/ethnicity represented an independent predictor of lower upstaging and/or upgrading in unfavorable IR PCa (OR 0.79, p < 0.001).
Race/ethnicity predisposes to differences in clinical, as well as in pathological characteristics in IR PCa patients. Specifically, even after full statistical adjustment, Hispanic/Latinos are at higher and African-Americans are at lower risk of upstaging and/or upgrading.
种族/民族可能使中危前列腺癌（IR PCa）患者的前列腺癌特征更差。我们在接受根治性前列腺切除术（RP）治疗的 IR PCa 患者亚组中对此假设进行了测试。
我们依赖于 Surveillance, Epidemiology and End Results 2004-2016。在预测 RP 时升期（pT3+/pN1）和/或升级（Gleason 分级组 [GGG] 4-5）的单变量和多变量逻辑回归分析中测试了种族/民族的影响。
在 20391 例 IR PCa 患者中，15050 例（73.8%）为白种人，2857 例（14.0%）为非裔美国人，1632 例（8.0%）为西班牙裔/拉丁裔，852 例（4.2%）为亚洲人。亚洲患者表现出最高的年龄（64 岁）、最高的 PSA（6.8ng/ml）和最高的 GGG3 比例（31.9%）。非裔美国人在活检中阳性核心的比例最高（41.7%），NCCN 不利风险组的比例最高（54.6%）。相反，白种人表现出最高的 cT2 期比例（35.6%）。在单变量分析中，在所有种族/民族中，西班牙裔/拉丁裔在有利和不利的分组中均显示出最高的升期/升级率，其次是亚洲人、白种人和非裔美国人。在多变量分析中，西班牙裔/拉丁裔种族/民族是有利的 IR PCa 中较高升期和/或升级的独立预测因子（优势比[OR] 1.27，p<0.01），而非裔美国人种族/民族是不利的 IR PCa 中较低升期和/或升级的独立预测因子（OR 0.79，p<0.001）。
种族/民族使 IR PCa 患者的临床和病理特征存在差异。具体来说，即使在充分的统计学调整后，西班牙裔/拉丁裔的升期和/或升级风险更高，而非裔美国人的风险更低。
