Active surveillance in prostate cancer is possible for Afro-Caribbean population: Comparison of oncological outcomes with a Caucasian cohort

Autor: C. Senechal, J.M. Ferriere, Pascal Blanchet, Franck Bladou, M. Percot, E. Alezra, Grégoire Capon, Laurent Brureau, V. Roux, J-C. Bernhard, G. Gourtaud, Henri Bensadoun, Remi Eyraud, Grégoire Robert
Přispěvatelé: CHU Bordeaux [Bordeaux], CHU Pointe-à-Pitre/Abymes [Guadeloupe], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
Rok vydání: 2020
Předmět:
Zdroj: Progrès en Urologie
Progrès en Urologie, 2020, 30 (10), pp.532-540. ⟨10.1016/j.purol.2020.05.006⟩
Progrès en Urologie, Elsevier Masson, 2020, 30 (10), pp.532-540. ⟨10.1016/j.purol.2020.05.006⟩
ISSN: 1166-7087
2405-5131
DOI: 10.1016/j.purol.2020.05.006⟩
Popis: Summary Background Prostate cancer is supposedly more aggressive among Afro-Caribbean men. There is a lack of data in this population for active surveillance. Published series are retrospective or have small samples and results are discordant. The objective was to determinate whether actual active surveillance modalities can be applied for Afro-Caribbean men by comparing their oncological outcomes with Caucasian men. Methods A total of 449 consecutive patients who underwent active surveillance for favorable-risk prostate cancer in two French University-Medical-Centers between 2005 and 2018: 261 in Guadeloupe, French West Indies, and 188 in Bordeaux, metropolitan France. Median follow-up was 56 months, (95% CI [32–81]) and 52 months (95% CI [30–75]), respectively (P = 0.07). Curative treatment was given in case of histological, biological, or imaging progression, or upon patient demand. Primary endpoints were treatment-free, overall and specific survival. Secondary outcomes were reasons of discontinuating active surveillance, histological poor prognosis factors after prostatectomy, CAPRA-S score, biochemical-recurrence-free after treatment and metastasis-free survival. Kaplan–Meier method was used. Results Median treatment free survival was 58.4 months (CI 95% [48.6–83.1]) for ACM and not reached at 120 months for CM (P = 0.002). Overall survival (P = 0.53), and specific survival (P = 0.21) were similar in the two groups. CM were likely to have poor prognosis factor on prostatecomy piece (57 vs 30%, P = 0.01). No difference for repartition of the CAPRA-S score (P = 0.86), biochemical-recurrence-free (P = 0.92) and metastasis-free (P = 0.44) survival. Conclusions Oncological outcomes for active surveillance of Afro-Caribbean and Caucasian men were similar in terms of mortality, recurrence and metastasis in our bicentric study, showing usability of current criteria for Afro-Caribbean. The higher rate of disease progression in the Afro-Caribbean population requires close monitoring. Level of evidence 3.
Databáze: OpenAIRE
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