Shemille A Collingwood1, Russell B McBride2, Michael Leapman1, Adele R Hobbs1, Young Suk Kwon3, Kristian D Stensland1, Rebecca M Schwartz4, Matthew E Pollard1, David B Samadi5. 1. Department of Urology, The Mount Sinai Medical Center, New York, NY. 2. Department of Pathology, The Mount Sinai Medical Center, New York, NY; The Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY. 3. Department of Urology, The Mount Sinai Medical Center, New York, NY; Department of Urology, Mercer University School of Medicine, New York, NY. 4. Department of Population Health, Hofstra North Shore LIJ School of Medicine, Great Neck, NY. 5. Department of Urology, North Shore LIJ-Lenox Hill Hospital, New York, NY. Electronic address: samadiroboticinstitute@gmail.com.
Abstract
OBJECTIVES: Longitudinal studies report racial disparities in prostate cancer (PCa) including greater incidence, more aggressive tumor biology, and increased cancer-specific mortality in African American (AA) men. Regret concerning primary treatment selection is underevaluated in patients with PCa. We investigated the relationships between clinicopathologic variables across racial and socioeconomic lines following robotic-assisted laparoscopic prostatectomy. MATERIALS AND METHODS: We assessed treatment decisional regret using a validated questionnaire in a total of 484 white and 72 AA patients with PCa who were followed up for a median of 16.6 months post-robotic-assisted laparoscopic prostatectomy. Socioeconomic status (SES) information was aggregated from 2010 US census zip code data. Perioperative clinicopathologic characteristics and functional outcomes were compared between groups. Univariate and multivariate regression analyses were used to evaluate the influence of race, aggregate SES, and other clinical and demographic characteristics on decisional regret. RESULTS: The majority (87.7%) of the population was not regretful of their decision to undergo treatment. However, a greater proportion of AA vs. white patients were regretful (20.6% vs. 11.2%, respectively; P = 0.03). AA and white men were similar on all functional, clinical, and pathologic features with the exception of younger age among AA men (56 vs. 60 y, respectively; P<0.001). Although there were significant differences in SES by race (P<0.001), regret did not differ by SES (β =-1.53; P = 0.15). Race, postoperative sexual dysfunction, pad usage, and length of hospital stay, however, were significantly associated with decisional regret. CONCLUSIONS: AA men were more regretful than white men, after adjusting for clinicopathologic characteristics and postoperative functional outcomes.
OBJECTIVES: Longitudinal studies report racial disparities in prostate cancer (PCa) including greater incidence, more aggressive tumor biology, and increased cancer-specific mortality in African American (AA) men. Regret concerning primary treatment selection is underevaluated in patients with PCa. We investigated the relationships between clinicopathologic variables across racial and socioeconomic lines following robotic-assisted laparoscopic prostatectomy. MATERIALS AND METHODS: We assessed treatment decisional regret using a validated questionnaire in a total of 484 white and 72 AA patients with PCa who were followed up for a median of 16.6 months post-robotic-assisted laparoscopic prostatectomy. Socioeconomic status (SES) information was aggregated from 2010 US census zip code data. Perioperative clinicopathologic characteristics and functional outcomes were compared between groups. Univariate and multivariate regression analyses were used to evaluate the influence of race, aggregate SES, and other clinical and demographic characteristics on decisional regret. RESULTS: The majority (87.7%) of the population was not regretful of their decision to undergo treatment. However, a greater proportion of AA vs. white patients were regretful (20.6% vs. 11.2%, respectively; P = 0.03). AA and white men were similar on all functional, clinical, and pathologic features with the exception of younger age among AA men (56 vs. 60 y, respectively; P<0.001). Although there were significant differences in SES by race (P<0.001), regret did not differ by SES (β =-1.53; P = 0.15). Race, postoperative sexual dysfunction, pad usage, and length of hospital stay, however, were significantly associated with decisional regret. CONCLUSIONS: AA men were more regretful than white men, after adjusting for clinicopathologic characteristics and postoperative functional outcomes.
Authors: B A Mahal; M-H Chen; C L Bennett; M W Kattan; O Sartor; K Stein; A V D'Amico; P L Nguyen Journal: Prostate Cancer Prostatic Dis Date: 2014-10-28 Impact factor: 5.554
Authors: Otis L Owens; Robin M Estrada; Kim Johnson; Micheal Cogdell; Daniel B Fried; Lucy Gansauer; Simon Kim Journal: Ethn Health Date: 2019-04-15 Impact factor: 2.772