School of Medicine and Health Science, Tecnologico de Monterrey, Monterrey, Nuevo Leon, Mexico.
Department of Medicine, University of Arizona, AZ.
Clin Genitourin Cancer. 2024 Feb;22(1):e148-e155.e1. doi: 10.1016/j.clgc.2023.10.002. Epub 2023 Oct 6.
Among Hispanic-American (HA) men, prostatic cancer (PCa) accounts for nearly one-quarter of the total cancer burden. We sought to identify differences in PCa presentation and treatment status for HA subgroups based on country/region of origin.
Using the National Cancer Database, we identified patients with histologically confirmed prostate adenocarcinoma with reported race/ethnicity, clinical staging, Gleason score ≥ 6, and PSA level at diagnosis from 2010 to 2016. HAs were divided into 4 subgroups: Mexican, Puerto Ricans, Cubans, and Central/South Americans. Non-Hispanic White (NHW) men were used as a reference group. Statistical analysis was derived from the Kruskal-Wallis test for continuous variables and χ test for categorical variables. Models were constructed to evaluate the association of Hispanic country of origin with metastatic presentation and treatment status.
A total of 428,829 patients were included, with 5625 (1.3%) classified as HA. Within the Hispanic group, 2880 (51.2%) were Mexican, 999 (17.8%) Puerto Rican, 477 (8.5%) Cuban, and 1269 (22.6%) South/Central American. Mexican men presented with higher median PSA, more Gleason 8 to 10 disease, and higher rates of metastatic presentation compared to NHW and other HA subgroups (all, p < .01). Metastatic rates over the study period for Mexican, Puerto Rican, Cuban, and South/Central Americans were 6.4 (±1.2), 5.3 (±3.0), 3.2 (±2.0), and 4.6% (±1.7), respectively (p = .01). Treatment rates were 89.1, 89.6, 92.4, and 89.3% for Mexican, Puerto Rican, Cuban, and South/Central Americans, respectively (p = .19). Mexican men had higher odds of initial metastatic presentation (OR: 1.32; 95%CI: 1.07-1.63, p = .01) but lower odds of receiving treatment (0.68; 0.55-0.85, p < .01).
Men of Mexican origin presented with more advanced PCa when compared to NHW and other Hispanic subgroups. Our results warrant further investigation into potential biological factors affecting Hispanic patients as well as the identification of treatment barriers for this vulnerable population.
在西班牙裔美国男性中，前列腺癌（PCa）占总癌症负担的近四分之一。我们试图根据原籍国/地区确定西班牙裔亚组中 PCa 表现和治疗状况的差异。
使用国家癌症数据库，我们确定了 2010 年至 2016 年期间报告种族/民族、临床分期、Gleason 评分≥6 和诊断时 PSA 水平的组织学证实前列腺腺癌患者。西班牙裔被分为 4 个亚组：墨西哥人、波多黎各人、古巴人和中/南美洲人。非西班牙裔白人（NHW）男性被用作参考组。连续变量的 Kruskal-Wallis 检验和分类变量的卡方检验得出统计学分析。构建模型评估西班牙裔原籍国与转移性表现和治疗状况的关联。
共纳入 428829 例患者，其中 5625 例（1.3%）为西班牙裔。在西班牙裔组中，2880 例（51.2%）为墨西哥人，999 例（17.8%）为波多黎各人，477 例（8.5%）为古巴人，1269 例（22.6%）为中/南美洲人。与 NHW 和其他西班牙裔亚组相比，墨西哥男性的中位 PSA 更高，Gleason 8-10 疾病更多，转移性表现率更高（均 p <.01）。研究期间墨西哥、波多黎各、古巴和中/南美洲人的转移性发生率分别为 6.4（±1.2）、5.3（±3.0）、3.2（±2.0）和 4.6%（±1.7）（p =.01）。墨西哥、波多黎各、古巴和中/南美洲人的治疗率分别为 89.1、89.6、92.4 和 89.3%（p =.19）。墨西哥男性初始转移性表现的可能性更高（OR：1.32；95%CI：1.07-1.63，p =.01），但接受治疗的可能性更低（0.68；0.55-0.85，p <.01）。
与 NHW 和其他西班牙裔亚组相比，墨西哥裔男性的 PCa 表现更具侵袭性。我们的结果表明，需要进一步研究影响西班牙裔患者的潜在生物学因素，以及确定这一脆弱人群的治疗障碍。
