Christoph Würnschimmel1,2,3, Luigi Nocera4,5, Mike Wenzel4,6, Claudia Collà Ruvolo4,7, Zhe Tian4, Fred Saad4, Alberto Briganti5, Shahrokh F Shariat8,9,10,11,12,13, Vincenzo Mirone7, Felix K H Chun6, Derya Tilki14, Markus Graefen14, Pierre I Karakiewicz4. 1. Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany. c.wuernschimmel@gmail.com. 2. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada. c.wuernschimmel@gmail.com. 3. Department of Urology, Lucerne Cantonal Hospital, Lucerne, Switzerland. c.wuernschimmel@gmail.com. 4. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada. 5. Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IBCAS San Raffaele Scientific Institute, Milan, Italy. 6. Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany. 7. Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, 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. 14. Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Abstract
PURPOSE: To test the effect of race/ethnicity on Social Security Administration (SSA) life tables' life expectancy (LE) predictions in localized prostate cancer (PCa) patients treated with either radical prostatectomy (RP) or external beam radiotherapy (EBRT). We hypothesized that LE will be affected by race/ethnicity. PATIENTS AND METHODS: We relied on the 2004-2006 Surveillance, Epidemiology, and End Results database to identify D'Amico intermediate- and high-risk PCa patients treated with either RP or EBRT. SSA life tables were used to compute 10-year LE predictions and were compared to OS. Stratification was performed according to treatment type (RP/EBRT) and race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic/Latino, and Asian). RESULTS: Of 55,383 assessable patients, 40,490 were non-Hispanic White (RP 49.3% vs. EBRT 50.7%), 7194 non-Hispanic Black (RP 41.3% vs. EBRT 50.7%), 4716 Hispanic/Latino (RP 51.0% vs. EBRT 49.0%) and 2983 were Asian (RP 41.6% vs. EBRT 58.4%). In both RP and EBRT patients, OS exceeded life tables' LE predictions, except for non-Hispanic Blacks. However, in RP patients, the magnitude of the difference was greater than in EBRT. Moreover, in RP patients, OS of non-Hispanic Blacks virtually perfectly followed predicted LE. Conversely, in EBRT patients, the OS of non-Hispanic Black patients was worse than predicted LE. CONCLUSIONS: When comparing SEER-derived observed OS with SSA life table-derived predicted life expectancy, we recorded a survival disadvantage in non-Hispanic Black RP and EBRT patients, which was not the case in the three other races/ethnicities (non-Hispanic Whites, Hispanic/Latinos, and Asians). This discrepancy should ideally be confirmed within different registries, countries, and tumor entities. Furthermore, the source of these discrepant survival outcomes should be investigated and addressed by health care politics.
PURPOSE: To test the effect of race/ethnicity on Social Security Administration (SSA) life tables' life expectancy (LE) predictions in localized prostate cancer (PCa) patients treated with either radical prostatectomy (RP) or external beam radiotherapy (EBRT). We hypothesized that LE will be affected by race/ethnicity. PATIENTS AND METHODS: We relied on the 2004-2006 Surveillance, Epidemiology, and End Results database to identify D'Amico intermediate- and high-risk PCa patients treated with either RP or EBRT. SSA life tables were used to compute 10-year LE predictions and were compared to OS. Stratification was performed according to treatment type (RP/EBRT) and race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic/Latino, and Asian). RESULTS: Of 55,383 assessable patients, 40,490 were non-Hispanic White (RP 49.3% vs. EBRT 50.7%), 7194 non-Hispanic Black (RP 41.3% vs. EBRT 50.7%), 4716 Hispanic/Latino (RP 51.0% vs. EBRT 49.0%) and 2983 were Asian (RP 41.6% vs. EBRT 58.4%). In both RP and EBRT patients, OS exceeded life tables' LE predictions, except for non-Hispanic Blacks. However, in RP patients, the magnitude of the difference was greater than in EBRT. Moreover, in RP patients, OS of non-Hispanic Blacks virtually perfectly followed predicted LE. Conversely, in EBRT patients, the OS of non-Hispanic Black patients was worse than predicted LE. CONCLUSIONS: When comparing SEER-derived observed OS with SSA life table-derived predicted life expectancy, we recorded a survival disadvantage in non-Hispanic Black RP and EBRT patients, which was not the case in the three other races/ethnicities (non-Hispanic Whites, Hispanic/Latinos, and Asians). This discrepancy should ideally be confirmed within different registries, countries, and tumor entities. Furthermore, the source of these discrepant survival outcomes should be investigated and addressed by health care politics.
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