Luigi Nocera1,2, Mike Wenzel3,4, Claudia Collà Ruvolo3,5, Christoph Würnschimmel3,6, Zhe Tian3, Giorgio Gandaglia7, Nicola Fossati7, Felix K H Chun4, Vincenzo Mirone5, Markus Graefen6, Fred Saad3, Shahrokh F Shariat8,9,10,11,12,13, Francesco Montorsi7, Alberto Briganti7, Pierre I Karakiewicz3. 1. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada. nocera.luigi@hsr.it. 2. Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, IRCCS Ospedale San Raffaele, Università Vita-Salute San Raffaele, Via Olgettina 60, 20132, Milan, Italy. nocera.luigi@hsr.it. 3. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada. 4. Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany. 5. Department of Urology, University of Naples Federico II, Naples, Italy. 6. Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany. 7. Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, IRCCS Ospedale San Raffaele, Università Vita-Salute San Raffaele, Via Olgettina 60, 20132, Milan, Italy. 8. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. 9. Departments of Urology, Weill Cornell Medical College, New York, NY, USA. 10. Department of Urology, University of Texas Southwestern, Dallas, TX, USA. 11. Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic. 12. Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia. 13. Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan.
Abstract
BACKGROUND: Race/ethnicity may predispose to less favorable prostate cancer characteristics in intermediate risk prostate cancer (IR PCa) patients. We tested this hypothesis in a subgroup of IR PCa patients treated with radical prostatectomy (RP). METHODS: We relied on the Surveillance, Epidemiology and End Results 2004-2016. The effect of race/ethnicity was tested in univariable and multivariable logistic regression analyses predicting upstaging (pT3+/pN1) and/or upgrading (Gleason Grade Group [GGG] 4-5) at RP. RESULTS: Of 20,391 IR PCa patients, 15,050 (73.8%) were Caucasian, 2857 (14.0%) African-American, 1632 (8.0%) Hispanic/Latino and 852 (4.2%) Asian. Asian patients exhibited highest age (64 year), highest PSA (6.8 ng/ml) and highest rate of GGG3 (31.9%). African-Americans exhibited the highest percentage of positive cores at biopsy (41.7%) and the highest proportion of NCCN unfavorable risk group membership (54.6%). Conversely, Caucasians exhibited the highest proportion of cT2 stage (35.6%). In univariable analyses, Hispanic/Latinos exhibited the highest rates of upstaging/upgrading among all race/ethnicities, in both favorable and unfavorable groups, followed by Asians, Caucasians and African-Americans in that order. In multivariable analyses, Hispanic/Latino race/ethnicity represented an independent predictor of higher upstaging and/or upgrading in favorable IR PCa (odds ratio [OR] 1.27, p < 0.01), while African-American race/ethnicity represented an independent predictor of lower upstaging and/or upgrading in unfavorable IR PCa (OR 0.79, p < 0.001). CONCLUSION: Race/ethnicity predisposes to differences in clinical, as well as in pathological characteristics in IR PCa patients. Specifically, even after full statistical adjustment, Hispanic/Latinos are at higher and African-Americans are at lower risk of upstaging and/or upgrading.
BACKGROUND: Race/ethnicity may predispose to less favorable prostate cancer characteristics in intermediate risk prostate cancer (IR PCa) patients. We tested this hypothesis in a subgroup of IR PCa patients treated with radical prostatectomy (RP). METHODS: We relied on the Surveillance, Epidemiology and End Results 2004-2016. The effect of race/ethnicity was tested in univariable and multivariable logistic regression analyses predicting upstaging (pT3+/pN1) and/or upgrading (Gleason Grade Group [GGG] 4-5) at RP. RESULTS: Of 20,391 IR PCa patients, 15,050 (73.8%) were Caucasian, 2857 (14.0%) African-American, 1632 (8.0%) Hispanic/Latino and 852 (4.2%) Asian. Asian patients exhibited highest age (64 year), highest PSA (6.8 ng/ml) and highest rate of GGG3 (31.9%). African-Americans exhibited the highest percentage of positive cores at biopsy (41.7%) and the highest proportion of NCCN unfavorable risk group membership (54.6%). Conversely, Caucasians exhibited the highest proportion of cT2 stage (35.6%). In univariable analyses, Hispanic/Latinos exhibited the highest rates of upstaging/upgrading among all race/ethnicities, in both favorable and unfavorable groups, followed by Asians, Caucasians and African-Americans in that order. In multivariable analyses, Hispanic/Latino race/ethnicity represented an independent predictor of higher upstaging and/or upgrading in favorable IR PCa (odds ratio [OR] 1.27, p < 0.01), while African-American race/ethnicity represented an independent predictor of lower upstaging and/or upgrading in unfavorable IR PCa (OR 0.79, p < 0.001). CONCLUSION: Race/ethnicity predisposes to differences in clinical, as well as in pathological characteristics in IR PCa patients. Specifically, even after full statistical adjustment, Hispanic/Latinos are at higher and African-Americans are at lower risk of upstaging and/or upgrading.
Authors: Luigi Nocera; Claudia Collà Ruvolo; Lara F Stolzenbach; Marina Deuker; Zhe Tian; Giorgio Gandaglia; Nicola Fossati; Firas Abdollah; Nazareno Suardi; Vincenzo Mirone; Markus Graefen; Felix K Chun; Fred Saad; Francesco Montorsi; Alberto Briganti; Pierre I Karakiewicz Journal: Minerva Urol Nephrol Date: 2021-04-22
Authors: Helen Y Hougen; Oleksii A Iakymenko; Sanoj Punnen; Chad R Ritch; Bruno Nahar; Dipen J Parekh; Oleksandr N Kryvenko; Mark L Gonzalgo Journal: World J Urol Date: 2022-06-10 Impact factor: 3.661
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