Do Hispanic Puerto Rican men have worse outcomes after radical prostatectomy? Results from SEARCH.

Autor: Guerrios-Rivera L; Urology Section, Surgery Department, Veterans Administration Caribbean Healthcare System, San Juan, Puerto Rico.; University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico., Janes JL; Section of Urology, Division of Surgery, Durham VA Health Care System, Durham, North Carolina, USA., De Hoedt AM; Section of Urology, Division of Surgery, Durham VA Health Care System, Durham, North Carolina, USA., Klaassen Z; Department of Surgery, Section of Urology, Augusta University - Medical College of Georgia, Augusta, Georgia, USA.; Charlie Norwood VA Medical Center, Augusta, Georgia, USA., Terris MK; Department of Surgery, Section of Urology, Augusta University - Medical College of Georgia, Augusta, Georgia, USA.; Charlie Norwood VA Medical Center, Augusta, Georgia, USA., Cooperberg MR; Department of Urology, Diller Family Comprehensive Cancer Center, UCSF Helen, San Francisco, California, USA., Amling CL; Department of Urology, Oregon Health and Science University School of Medicine, Portland, Oregon, USA., Kane CJ; Department of Urology, UC San Diego Health System, San Diego, California, USA.; VA San Diego Healthcare System, San Diego, California, USA., Aronson WJ; Department of Urology, UCLA Medical Center, Los Angeles, California, USA.; Wadsworth VA Medical Center, Los Angeles, California, USA., Fowke JH; Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Division of Epidemiology, Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA., Freedland SJ; Section of Urology, Division of Surgery, Durham VA Health Care System, Durham, North Carolina, USA.; Center for Integrated Research in Cancer and Lifestyle, Division of Urology, Department of Surgery, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Jazyk: angličtina
Zdroj: Cancer medicine [Cancer Med] 2024 Feb; Vol. 13 (4), pp. e7012.
DOI: 10.1002/cam4.7012
Abstrakt: Background: We previously reported that outcomes after radical prostatectomy (RP) were similar among non-Hispanic Black, non-Hispanic White, and Hispanic White Veterans Affairs (VA) patients. However, prostate cancer (PC) mortality in Puerto Rican Hispanics (PRH) may be higher than in other Hispanic groups. Data focused on PRH patients is sparse; thus, we tested the association between PR ethnicity and outcomes after RP.
Methods: Analysis included men in SEARCH cohort who underwent RP (1988-2020, n = 8311). PRH patients (n = 642) were treated at the PR VA, and outcomes were compared to patients treated in the Continental US regardless of race. Logistic regression was used to test the associations between PRH and PC aggressiveness, adjusting for demographic and clinicopathological features. Multivariable Cox models were used to investigate PRH versus Continental differences in biochemical recurrence (BCR), metastases, castration-resistant PC (CRPC), and PC-specific mortality (PCSM).
Results: Compared to Continental patients, PRH patients had lower adjusted odds of pathological grade group ≥2 (p < 0.001), lymph node metastasis (p < 0.001), and positive margins (p < 0.001). In contrast, PRH patients had higher odds of extracapsular extension (p < 0.001). In Cox models, PRH patients had a higher risk for BCR (HR = 1.27, p < 0.001), metastases (HR = 1.49, p = 0.014), CRPC (HR = 1.80, p = 0.001), and PCSM (HR = 1.74, p = 0.011). Further adjustment for extracapsular extension and other pathological variables strengthened these findings.
Conclusions: In an equal access setting, PRH RP patients generally had better pathological features, but despite this, they had significantly worse post-treatment outcomes than men from the Continental US, regardless of race. The reasons for the poorer prognosis among PRH men require further research.
(© 2024 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.)
Databáze: MEDLINE
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