Department of Urology, University of Illinois at Chicago, Chicago, IL.
Department of Urology, University of Illinois at Chicago, Chicago, IL.
Urology. 2022 Jul;165:218-226. doi: 10.1016/j.urology.2022.02.025. Epub 2022 Mar 26.
To evaluate the differences in prostate cancer characteristics and treatment between Hispanic Americans with different countries of origin using the National Cancer Database.
We performed a retrospective analysis of 54,947 adult Hispanic Americans diagnosed with prostate cancer between 2004 and 2015. Origin was Mexican (N = 7844; 14.3%), South/Central American (N = 4010; 7.3%), Puerto Rican (N = 2938; 5.4%), Cuban (N = 2549; 4.6%), Dominican (N = 1535; 2.8%), Hispanic not specified (N = 36,269; 65.7%). Comparison between characteristics among Hispanic American sub-groups' categories was performed using chi-square and Kruskal-Wallis tests for categorical and continuous variables respectively.
Mexicans had overall worse disease at presentation including highest median PSA (7.8 ng/mL), most prevalent T3/T4 stage (6.7%), M1 stage (8.9%), and high-grade Gleason scores (24.0%) when compared to all other Hispanic American groups. Cubans were most likely to receive hormone therapy and radiation therapy and least likely to receive surgical treatment. Compared to Mexicans, Cubans (hazards ratio [HR] = 1.30, 95% confidence interval = [1.16-1.44]) had worse overall survival, while Puerto Ricans (HR = 1.08 [0.95-1.19] had similar overall survival, and Dominicans (HR = 0.63 [0 0.53-0.75]), South/Central Americans (HR = 0.75, [0.66-0.84]) and not specified (HR = 0.84 [0.79-0.91]) had better survival.
Among Hispanic Americans with different countries of origin, disparities in prostate cancer characteristics, treatment choice, and survival do exist. Mexicans had the least favorable prostate cancer characteristics at presentation. Cubans had the worst overall survival while they were also most likely to receive hormone and/or radiation as first-line treatment. Our analysis demonstrates significant heterogeneity in the Hispanic American population.
利用国家癌症数据库评估具有不同原籍国的美籍西班牙裔人群的前列腺癌特征和治疗差异。
我们对 2004 年至 2015 年间诊断为前列腺癌的 54947 名成年美籍西班牙裔患者进行了回顾性分析。原籍为墨西哥（n=7844；14.3%）、南美/中美（n=4010；7.3%）、波多黎各（n=2938；5.4%）、古巴（n=2549；4.6%）、多米尼加（n=1535；2.8%）、未具体说明（n=36269；65.7%）。使用卡方检验和 Kruskal-Wallis 检验分别比较美籍西班牙裔亚组的特征。
与其他所有美籍西班牙裔人群相比，墨西哥裔患者总体疾病表现较差，包括中位 PSA 最高（7.8ng/ml）、最常见的 T3/T4 期（6.7%）、M1 期（8.9%）和高级别 Gleason 评分（24.0%）。古巴裔患者最有可能接受激素治疗和放疗，而最不可能接受手术治疗。与墨西哥裔患者相比，古巴裔患者的总生存较差（风险比[HR]为 1.30，95%置信区间[1.16-1.44]），而波多黎各裔患者的总生存相似（HR为 1.08[0.95-1.19]），多米尼加裔患者（HR为 0.63[0.53-0.75]）、南/中美洲裔患者（HR为 0.75[0.66-0.84]）和未具体说明的患者（HR为 0.84[0.79-0.91]）生存情况较好。
在具有不同原籍国的美籍西班牙裔人群中，前列腺癌特征、治疗选择和生存方面存在差异。墨西哥裔患者在发病时的前列腺癌特征最不理想。古巴裔患者的总生存最差，而他们也最有可能接受激素和/或放疗作为一线治疗。我们的分析表明，美籍西班牙裔人群存在显著的异质性。
