Mike Wenzel1,2, Luigi Nocera2,3, Claudia Collà Ruvolo2,4, Christoph Würnschimmel2,5, Zhe Tian2, Shahrokh F Shariat6,7,8,9,10,11, Fred Saad2, Alberto Briganti3, Derya Tilki5, Markus Graefen5, Luis A Kluth1, Philipp Mandel1, Felix K H Chun1, Pierre I Karakiewicz2. 1. Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany. 2. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada. 3. Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IBCAS San Raffaele Scientific Institute, Milan, Italy. 4. Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Italy. 5. Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany. 6. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. 7. Departments of Urology, Weill Cornell Medical College, New York, New York. 8. Department of Urology, University of Texas Southwestern, Dallas, Texas. 9. Department of Urology, Second Faculty of Medicine, Charles University, Prag, Czech Republic. 10. Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia. 11. Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan.
Abstract
PURPOSE: We hypothesized that differences in active treatment rates may exist according to race/ethnicity in favorable as well as unfavorable intermediate risk prostate cancer. MATERIALS AND METHODS: We relied on the Surveillance, Epidemiology, and End Results 18 database 2010-2015. We stratified according to 3 racial/ethnic groups (White vs Black vs Hispanic) and prostate cancer baseline characteristics (prostate specific antigen, clinical T stage, Gleason group grading, percentage of biopsy cores). We tabulated active treatment rates (radical prostatectomy, external beam radiotherapy) without and with adjustment for baseline age and prostate cancer characteristics. RESULTS: Baseline prostate specific antigen, clinical T stage, Gleason grade and percentage of positive biopsy cores differed according to racial/ethnic groups in both favorable and unfavorable intermediate risk prostate cancer patients (all p <0.05). Similarly, radical prostatectomy and external beam radiotherapy rates differed according to race/ethnicity in both favorable and unfavorable intermediate risk prostate cancer patients. Radical prostatectomy and external beam radiotherapy rates respectively ranged from 31.7%-41.8% and 26.3%-31.0% in favorable intermediate risk cases and from 33.4%-43.9% and 30.9%-35.5% in unfavorable intermediate risk prostate cancer, across the 3 race/ethnicity groups (both p <0.05). The above heterogeneity in active treatment rates disappeared and marginal differences remained after adjustment for baseline age and prostate cancer characteristics. CONCLUSIONS: Interpretation of active treatment rates in favorable and unfavorable intermediate risk prostate cancer may be severely biased, unless detailed and systematic consideration or adjustment for baseline age and prostate cancer characteristic is enforced.
PURPOSE: We hypothesized that differences in active treatment rates may exist according to race/ethnicity in favorable as well as unfavorable intermediate risk prostate cancer. MATERIALS AND METHODS: We relied on the Surveillance, Epidemiology, and End Results 18 database 2010-2015. We stratified according to 3 racial/ethnic groups (White vs Black vs Hispanic) and prostate cancer baseline characteristics (prostate specific antigen, clinical T stage, Gleason group grading, percentage of biopsy cores). We tabulated active treatment rates (radical prostatectomy, external beam radiotherapy) without and with adjustment for baseline age and prostate cancer characteristics. RESULTS: Baseline prostate specific antigen, clinical T stage, Gleason grade and percentage of positive biopsy cores differed according to racial/ethnic groups in both favorable and unfavorable intermediate risk prostate cancerpatients (all p <0.05). Similarly, radical prostatectomy and external beam radiotherapy rates differed according to race/ethnicity in both favorable and unfavorable intermediate risk prostate cancerpatients. Radical prostatectomy and external beam radiotherapy rates respectively ranged from 31.7%-41.8% and 26.3%-31.0% in favorable intermediate risk cases and from 33.4%-43.9% and 30.9%-35.5% in unfavorable intermediate risk prostate cancer, across the 3 race/ethnicity groups (both p <0.05). The above heterogeneity in active treatment rates disappeared and marginal differences remained after adjustment for baseline age and prostate cancer characteristics. CONCLUSIONS: Interpretation of active treatment rates in favorable and unfavorable intermediate risk prostate cancer may be severely biased, unless detailed and systematic consideration or adjustment for baseline age and prostate cancer characteristic is enforced.
Authors: Francesco Chierigo; Marco Borghesi; Christoph Würnschimmel; Rocco Simone Flammia; Benedikt Horlemann; Gabriele Sorce; Benedikt Hoeh; Zhe Tian; Fred Saad; Markus Graefen; Michele Gallucci; Alberto Briganti; Francesco Montorsi; Felix K H Chun; Shahrokh F Shariat; Guglielmo Mantica; Nazareno Suardi; Carlo Terrone; Pierre I Karakiewicz Journal: Int Urol Nephrol Date: 2022-05-04 Impact factor: 2.370
Authors: Mike Wenzel; Christoph Würnschimmel; Luigi Nocera; Claudia Colla Ruvolo; Benedikt Hoeh; Zhe Tian; Shahrokh F Shariat; Fred Saad; Alberto Briganti; Markus Graefen; Felix Preisser; Andreas Becker; Philipp Mandel; Felix K H Chun; Pierre I Karakiewicz Journal: Front Oncol Date: 2022-08-19 Impact factor: 5.738
Authors: Mike Wenzel; Felix Preisser; Benedikt Hoeh; Maria N Welte; Clara Humke; Clarissa Wittler; Christoph Würnschimmel; Andreas Becker; Pierre I Karakiewicz; Felix K H Chun; Philipp Mandel; Luis A Kluth Journal: Front Surg Date: 2021-12-09