Kosj Yamoah1, Curtiland Deville2, Neha Vapiwala2, Elaine Spangler2, Charnita M Zeigler-Johnson3, Bruce Malkowicz2, David I Lee2, Michael Kattan4, Adam P Dicker3, Timothy R Rebbeck2. 1. Department of Radiation Oncology, Sidney Kimmel Cancer Center and Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA. Electronic address: Kosj.Yamoah@Jeffersonhospital.org. 2. The Abramson Cancer Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA. 3. Department of Radiation Oncology, Sidney Kimmel Cancer Center and Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA. 4. Cleveland Clinic, Cleveland, OH.
Abstract
PURPOSE: To explore whether disparities in outcomes exist between African American (AA) and Caucasian (CS) men with low-grade prostate cancer and similar cancer of the prostate risk assessment-postsurgery (CAPRA-S) features following prostatectomy (RP). METHODS: The overall cohort consisted of 1,265 men (234 AA and 1,031 CS) who met the National comprehensive cancer network criteria for low- to intermediate-risk prostate cancer and underwent RP between 1990 and 2012. We first evaluated whether clinical factors were associated with adverse pathologic outcomes and freedom from biochemical failure (FFbF) using the entire cohort. Next, we studied a subset of 705 men (112 AA and 593 CS) who had pathologic Gleason score≤6 (low-grade disease). Using this cohort, we determined whether race affected FFbF in men with RP-proven low-grade disease and similar CAPRA-S scores. RESULTS: With a median follow-up time of 27 months, the overall 7-year FFbF rate was 86% vs. 79% in CS and AA men, respectively (P = 0.035). There was no significant difference in one or more adverse pathologic features between CS vs. AA men (27% vs. 31%; P = 0.35) or CAPRA-S score (P = 0.28). In the subset analysis of patients with low-grade disease, AA race was associated with worse FFbF outcomes (P = 0.002). Furthermore, AA race was a significant predictor of FFbF in men with low-grade disease (hazard ratio = 2.01, 95% CI: 1.08-3.72; P = 0.029). CONCLUSIONS: AA race is a predictor of worse FFbF outcomes in men with low-grade disease after RP. These results suggest that a subset of AA men with low-grade disease may benefit from more aggressive treatment.
PURPOSE: To explore whether disparities in outcomes exist between African American (AA) and Caucasian (CS) men with low-grade prostate cancer and similar cancer of the prostate risk assessment-postsurgery (CAPRA-S) features following prostatectomy (RP). METHODS: The overall cohort consisted of 1,265 men (234 AA and 1,031 CS) who met the National comprehensive cancer network criteria for low- to intermediate-risk prostate cancer and underwent RP between 1990 and 2012. We first evaluated whether clinical factors were associated with adverse pathologic outcomes and freedom from biochemical failure (FFbF) using the entire cohort. Next, we studied a subset of 705 men (112 AA and 593 CS) who had pathologic Gleason score≤6 (low-grade disease). Using this cohort, we determined whether race affected FFbF in men with RP-proven low-grade disease and similar CAPRA-S scores. RESULTS: With a median follow-up time of 27 months, the overall 7-year FFbF rate was 86% vs. 79% in CS and AA men, respectively (P = 0.035). There was no significant difference in one or more adverse pathologic features between CS vs. AA men (27% vs. 31%; P = 0.35) or CAPRA-S score (P = 0.28). In the subset analysis of patients with low-grade disease, AA race was associated with worse FFbF outcomes (P = 0.002). Furthermore, AA race was a significant predictor of FFbF in men with low-grade disease (hazard ratio = 2.01, 95% CI: 1.08-3.72; P = 0.029). CONCLUSIONS: AA race is a predictor of worse FFbF outcomes in men with low-grade disease after RP. These results suggest that a subset of AA men with low-grade disease may benefit from more aggressive treatment.
Authors: M J Resnick; D J Canter; T J Guzzo; B M Brucker; M Bergey; S S Sonnad; A J Wein; S B Malkowicz Journal: Urology Date: 2008-12-18 Impact factor: 2.649
Authors: James Mohler; Robert R Bahnson; Barry Boston; J Erik Busby; Anthony D'Amico; James A Eastham; Charles A Enke; Daniel George; Eric Mark Horwitz; Robert P Huben; Philip Kantoff; Mark Kawachi; Michael Kuettel; Paul H Lange; Gary Macvicar; Elizabeth R Plimack; Julio M Pow-Sang; Mack Roach; Eric Rohren; Bruce J Roth; Dennis C Shrieve; Matthew R Smith; Sandy Srinivas; Przemyslaw Twardowski; Patrick C Walsh Journal: J Natl Compr Canc Netw Date: 2010-02 Impact factor: 11.908
Authors: Marc A Dall'Era; Peter C Albertsen; Christopher Bangma; Peter R Carroll; H Ballentine Carter; Matthew R Cooperberg; Stephen J Freedland; Laurence H Klotz; Christopher Parker; Mark S Soloway Journal: Eur Urol Date: 2012-06-07 Impact factor: 20.096
Authors: Debasish Sundi; Ashley E Ross; Elizabeth B Humphreys; Misop Han; Alan W Partin; H Ballentine Carter; Edward M Schaeffer Journal: J Clin Oncol Date: 2013-06-17 Impact factor: 44.544
Authors: Christopher A Haiman; Gary K Chen; William J Blot; Sara S Strom; Sonja I Berndt; Rick A Kittles; Benjamin A Rybicki; William B Isaacs; Sue A Ingles; Janet L Stanford; W Ryan Diver; John S Witte; Stephen J Chanock; Suzanne Kolb; Lisa B Signorello; Yuko Yamamura; Christine Neslund-Dudas; Michael J Thun; Adam Murphy; Graham Casey; Xin Sheng; Peggy Wan; Loreall C Pooler; Kristine R Monroe; Kevin M Waters; Loic Le Marchand; Laurence N Kolonel; Daniel O Stram; Brian E Henderson Journal: PLoS Genet Date: 2011-05-26 Impact factor: 5.917
Authors: Michael S Leapman; Stephen J Freedland; William J Aronson; Christopher J Kane; Martha K Terris; Kelly Walker; Christopher L Amling; Peter R Carroll; Matthew R Cooperberg Journal: J Urol Date: 2016-06-25 Impact factor: 7.450
Authors: Michael Kongnyuy; Abhinav Sidana; Arvin K George; Akhil Muthigi; Amogh Iyer; Michele Fascelli; Meet Kadakia; Thomas P Frye; Richard Ho; Francesca Mertan; M Minhaj Siddiqui; Daniel Su; Maria J Merino; Baris Turkbey; Peter L Choyke; Bradford J Wood; Peter A Pinto Journal: Urol Oncol Date: 2016-02-20 Impact factor: 3.498
Authors: Michelle I Echevarria; Shivanshu Awasthi; Chia-Ho Cheng; Anders E Berglund; Robert J Rounbehler; Travis A Gerke; Mandeep Takhar; Elai Davicioni; Eric A Klein; Stephen J Freedland; Ashley E Ross; Edward M Schaeffer; Robert B Den; John L Cleveland; Jong Y Park; Walter Rayford; Kosj Yamoah Journal: J Urol Date: 2019-07-08 Impact factor: 7.450
Authors: Roble G Bedolla; Dimpy P Shah; Shih-Bo Huang; Robert L Reddick; Rita Ghosh; Addanki P Kumar Journal: Mol Carcinog Date: 2019-03-11 Impact factor: 4.784
Authors: Shivanshu Awasthi; Travis Gerke; Jong Y Park; Francis A Asamoah; Vonetta L Williams; Angelina K Fink; Rajesh Balkrishnan; David I Lee; S Bruce Malkowicz; Priti Lal; Jasreman Dhillon; Julio M Pow-Sang; Timothy R Rebbeck; Kosj Yamoah Journal: Cancer Epidemiol Biomarkers Prev Date: 2018-11-09 Impact factor: 4.254
Authors: Anita D Misra-Hebert; Bo Hu; Eric A Klein; Andrew Stephenson; Glen B Taksler; Michael W Kattan; Michael B Rothberg Journal: BJU Int Date: 2017-02-26 Impact factor: 5.588
Authors: Jeffrey M Bhasin; Byron H Lee; Lars Matkin; Margaret G Taylor; Bo Hu; Yaomin Xu; Cristina Magi-Galluzzi; Eric A Klein; Angela H Ting Journal: Cell Rep Date: 2015-11-25 Impact factor: 9.423
Authors: Baris Turkbey; Anna M Brown; Sandeep Sankineni; Bradford J Wood; Peter A Pinto; Peter L Choyke Journal: CA Cancer J Clin Date: 2015-11-23 Impact factor: 508.702