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Black Race Does Not Independently Predict Adverse Outcome Following Radical Retropubic Prostatectomy at a Tertiary Referral Center

医学 根治性耻骨后前列腺切除术 中心(范畴论) 前列腺切除术 种族(生物学) 介绍 不利影响 泌尿科 内科学 家庭医学 前列腺癌 癌症 化学 结晶学 植物 生物
作者
Matthew E. Nielsen,Misop Han,Leslie A. Mangold,Elizabeth B. Humphreys,Patrick C. Walsh,Alan W. Partin,Stephen J. Freedland
出处
期刊:The Journal of Urology [Ovid Technologies (Wolters Kluwer)]
卷期号:176 (2): 515-519 被引量:39
标识
DOI:10.1016/j.juro.2006.03.100
摘要

No AccessJournal of UrologyAdult urology1 Aug 2006Black Race Does Not Independently Predict Adverse Outcome Following Radical Retropubic Prostatectomy at a Tertiary Referral Centeris accompanied byThe E-Cadherin −160 C/A Polymorphism and Prostate Cancer Risk in White and Black American MenRadical Prostatectomy—Which Patients Benefit Most From Surgery? Matthew E. Nielsen, Misop Han, Leslie Mangold, Elizabeth Humphreys, Patrick C. Walsh, Alan W. Partin, and Stephen J. Freedland Matthew E. NielsenMatthew E. Nielsen Department of Urology, The Johns Hopkins School of Medicine, Baltimore, Maryland , Misop HanMisop Han Northwestern University Feinberg School of Medicine, Chicago, Illinois , Leslie MangoldLeslie Mangold Department of Urology, The Johns Hopkins School of Medicine, Baltimore, Maryland , Elizabeth HumphreysElizabeth Humphreys Department of Urology, The Johns Hopkins School of Medicine, Baltimore, Maryland , Patrick C. WalshPatrick C. Walsh Department of Urology, The Johns Hopkins School of Medicine, Baltimore, Maryland , Alan W. PartinAlan W. Partin Department of Urology, The Johns Hopkins School of Medicine, Baltimore, Maryland , and Stephen J. FreedlandStephen J. Freedland Department of Urology, The Johns Hopkins School of Medicine, Baltimore, Maryland View All Author Informationhttps://doi.org/10.1016/j.juro.2006.03.100AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: There is controversy in the literature as to whether black race is associated with poorer oncological outcomes among men undergoing radical prostatectomy for clinically localized prostate cancer. To address this issue we examined the outcomes of a cohort of black and white men treated by multiple surgeons at our institution. Materials and Methods: The study population consisted of 4,962 white and 326 black men treated with anatomical radical retropubic prostatectomy between 1988 and 2004 by 10 different surgeons at the Johns Hopkins Hospital, a tertiary care referral center. We evaluated the association between race and adverse pathological features, and biochemical progression. Results: Black men had significantly higher preoperative serum prostate specific antigen (mean 7.2 vs 6.0 ng/ml, p <0.001), body mass index (median 27.4 vs 26.3 kg/m2, p <0.001) and incidence of higher grade disease (Gleason sum 4 + 3 or greater) on prostate biopsy (17% vs 14%, p = 0.011). After adjustment for multiple clinical variables there was no statistically significant association between race and the adverse pathological characteristics of high grade disease, positive surgical margins, extraprostatic extension or seminal vesicle invasion. Black race was associated with a significantly increased risk of biochemical progression on univariate analysis (HR 1.52, 95% CI 1.16-2.00, p = 0.002). However, after adjusting for clinical and pathological characteristics, black race was not an independent predictor of biochemical progression (HR 1.09, 95% CI 0.81–1.45, p = 0.578). Conclusions: Black men were more likely to be obese and present with adverse preoperative clinical features at a younger age, and have a higher rate of biochemical progression. However, on multivariate analysis black race was not an independent predictor of adverse pathological outcome or biochemical recurrence. Further efforts are needed to detect prostate cancer earlier among black men. References 1 : SEER Cancer Statistics Review 1973-1998. Bethesda, Maryland: National Cancer Institute, National Institutes of Health2001. Google Scholar 2 : Recent trends in mortality rates for four major cancers, by sex and race/ethnicity—United States, 1990-1998. MMWR Morb Mortal Wkly Rep2002; 51: 49. Google Scholar 3 : Correlation of pathologic findings with progression after radical retropubic prostatectomy. Cancer1993; 71: 3582. Crossref, Medline, Google Scholar 4 : Epidemiology of radical prostatectomy for localized prostate cancer in the era of prostate-specific antigen: an overview of the Department of Defense Center for Prostate Disease Research national database. Surgery2002; 132: 213. Google Scholar 5 : Surgical control of clinically localized prostate carcinoma is equivalent in African-American and white males. Cancer1998; 83: 2353. Google Scholar 6 : Disease recurrence in black and white men undergoing radical prostatectomy for clinical stage T1-T2 prostate cancer. J Urol2000; 163: 143. Link, Google Scholar 7 : Impact of race on prostate-specific antigen outcome after radical prostatectomy for clinically localized adenocarcinoma of the prostate. J Clin Oncol2002; 20: 2863. Google Scholar 8 : Race is not an independent predictor of biochemical recurrence after radical prostatectomy in an equal access medical center. Urology2000; 56: 87. Crossref, Medline, Google Scholar 9 : Race as an outcome predictor after radical prostatectomy: results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database. Urology2002; 60: 670. Google Scholar 10 : Race as an independent predictor of outcome after treatment for localized prostate cancer. J Urol1999; 162: 1331. Link, Google Scholar 11 : Disease-free survival difference between African Americans and whites after radical prostatectomy for local prostate cancer: a multivariable analysis. Urology2002; 59: 907. Google Scholar 12 : Is ethnicity an independent predictor of prostate cancer recurrence after radical prostatectomy?. J Urol2002; 168: 2510. Link, Google Scholar 13 : Impact of socioeconomic status and race on clinical parameters of patients undergoing radical prostatectomy in an equal access health care system. Urology2000; 56: 1016. Google Scholar 14 : Black race is an adverse prognostic factor for prostate cancer recurrence following radical prostatectomy in an equal access health care setting. J Urol1996; 155: 1667. Link, Google Scholar 15 : The effect of race/ethnicity on prostate cancer treatment outcome is conditional: a review of Wayne State University data. J Urol2004; 171: 1508. Link, Google Scholar 16 : Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA2003; 289: 76. Google Scholar 17 : Impact of obesity on biochemical control after radical prostatectomy for clinically localized cancer: a report by the Shared Equal Access Regional Cancer Hospital database study group. J Clin Oncol2004; 22: 446. Google Scholar 18 : Pathologic variables and recurrence rates as related to obesity and race in men with prostate cancer undergoing radical prostatectomy. J Clin Oncol2004; 22: 439. Google Scholar 19 : Preoperative model for predicting prostate specific antigen recurrence after radical prostatectomy using percent of biopsy tissue with cancer, biopsy Gleason grade and serum prostate specific antigen. J Urol2004; 171: 2215. Google Scholar 20 : Risk of prostate cancer specific mortality following biochemical recurrence after radical prostatectomy. JAMA2005; 294: 433. Google Scholar © 2006 by American Urological AssociationFiguresReferencesRelatedDetailsCited byMitin T, Chen M, Zhang Y, Moran B, Dosoretz D, Katin M, Braccioforte M, Salenius S and D'Amico A (2011) Diabetes Mellitus, Race and the Odds of High Grade Prostate Cancer in Men Treated With Radiation TherapyJournal of Urology, VOL. 186, NO. 6, (2233-2238), Online publication date: 1-Dec-2011.Uhlman M, Sun L, Stackhouse D, Polascik T, Mouraviev V, Robertson C, Albala D and Moul J (2010) Tumor Percent Involvement Predicts Prostate Specific Antigen Recurrence After Radical Prostatectomy Only in Men With Smaller ProstateJournal of Urology, VOL. 183, NO. 3, (997-1002), Online publication date: 1-Mar-2010.Freedland S (2007) Obesity and Prostate Cancer: Importance of Race and Stage of DiseaseJournal of Urology, VOL. 178, NO. 5, (1842-1843), Online publication date: 1-Nov-2007.Related articlesJournal of Urology9 Nov 2018The E-Cadherin −160 C/A Polymorphism and Prostate Cancer Risk in White and Black American MenJournal of Urology9 Nov 2018Radical Prostatectomy—Which Patients Benefit Most From Surgery? Volume 176Issue 2August 2006Page: 515-519 Advertisement Copyright & Permissions© 2006 by American Urological AssociationKeywordsobesityprostatic neoplasmscontinental population groupsprostatectomyprostate-specific antigenMetricsAuthor Information Matthew E. Nielsen Department of Urology, The Johns Hopkins School of Medicine, Baltimore, Maryland More articles by this author Misop Han Northwestern University Feinberg School of Medicine, Chicago, Illinois More articles by this author Leslie Mangold Department of Urology, The Johns Hopkins School of Medicine, Baltimore, Maryland More articles by this author Elizabeth Humphreys Department of Urology, The Johns Hopkins School of Medicine, Baltimore, Maryland More articles by this author Patrick C. Walsh Department of Urology, The Johns Hopkins School of Medicine, Baltimore, Maryland More articles by this author Alan W. Partin Department of Urology, The Johns Hopkins School of Medicine, Baltimore, Maryland More articles by this author Stephen J. Freedland Department of Urology, The Johns Hopkins School of Medicine, Baltimore, Maryland More articles by this author Expand All Advertisement PDF downloadLoading ...
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