The effect of race/ethnicity on active treatment rates among septuagenarian or older low risk prostate cancer patients.

Autor: Nocera L; Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Quebec, Canada; Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy. Electronic address: nocera.luigi@hsr.it., Wenzel M; Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Quebec, Canada; Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany., Collà Ruvolo C; Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Quebec, Canada; Department of Urology, University of Naples Federico II, Naples, Italy., Würnschimmel C; Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Quebec, Canada; Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany., Tian Z; Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Quebec, Canada., Gandaglia G; Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy., Fossati N; Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy., Chun FKH; Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany., Mirone V; Department of Urology, University of Naples Federico II, Naples, Italy., Graefen M; Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany., Shariat SF; Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Departments of Urology, Weill Cornell Medical College, New York, NY; Department of Urology, University of Texas Southwestern, Dallas, TX; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan., Saad F; Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Quebec, Canada., Montorsi F; Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy., Briganti A; Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy., Karakiewicz PI; Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Quebec, Canada.
Jazyk: angličtina
Zdroj: Urologic oncology [Urol Oncol] 2021 Nov; Vol. 39 (11), pp. 785.e11-785.e17. Date of Electronic Publication: 2021 May 13.
DOI: 10.1016/j.urolonc.2021.04.004
Abstrakt: Background: Race/ethnicity may predispose to higher active treatment rates in septuagenarian or older low risk prostate cancer (CaP) patients. We tested this hypothesis within a contemporary North American cohort.
Material and Methods: We relied on the Surveillance, Epidemiology and End Results (SEER) database 2010-2016. The effect of race/ethnicity was tested in univariable and multivariable logistic regression analyses predicting definitive treatment administration. Treatment rates (no local treatment [NLT], external beam radiotherapy [EBRT], radical prostatectomy [RP] and brachytherapy) were examined without, as well as with adjustment for age, socioeconomic status, marital status, residence type, year of diagnosis, other-cause mortality, prostate-specific antigen (PSA) and clinical T stage across races/ethnicities. Moreover, temporal trend analyses were performed.
Results: Of 15,118 septuagenarian or older low risk CaP patients, 11,509 (76.1%) were Caucasian, 1,613 (10.7%) African-American, 1,293 (8.5%) Hispanic/Latino and 703 (4.7%) Asian. No clinically meaningful differences were recorded between races/ethnicities with respect to age at diagnosis, PSA, clinical T stage and percentage of positive biopsy cores. Conversely, clinically meaningful and statistically significant differences were identified in socioeconomic status and treatment modality. Specifically, treatment rates ranged as follows: NLT 41.8-48.2, EBRT 23.0-29.9, RP 13.8-21.8 and brachytherapy 6.4-9.9% across race/ethnicies. After adjustment for patient and tumor characteristics, NLT, EBRT, RP and brachytherapy rates showed virtually no residual heterogeneity between races/ethnicities. Finally, in temporal trend analyses, EBRT rates decreased in all races/ethnicities. Conversely, RP and brachytherapy rates did not change over time.
Conclusion: The rates of active treatment in septuagenarian or older low risk CaP patients are surprisingly elevated in all races/ethnicities, even though they decreased over time. All differences in active treatment rates according to race/ethnicity depend on baseline patient and tumor characteristics.
Competing Interests: Conflicts of interest The authors declare no competing interests.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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