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Titolo:
Race as an independent predictor of outcome after treatment for localized prostate cancer
Autore:
Sohayda, CJ; Kupelian, PA; Altsman, KA; Klein, EA;
Indirizzi:
Cleveland Clin Fdn, Dept Radiat Oncol, Cleveland, OH 44195 USA Cleveland Clin Fdn Cleveland OH USA 44195 Oncol, Cleveland, OH 44195 USA Cleveland Clin Fdn, Dept Urol, Cleveland, OH 44195 USA Cleveland Clin FdnCleveland OH USA 44195 t Urol, Cleveland, OH 44195 USA
Titolo Testata:
JOURNAL OF UROLOGY
fascicolo: 4, volume: 162, anno: 1999,
pagine: 1331 - 1336
SICI:
0022-5347(199910)162:4<1331:RAAIPO>2.0.ZU;2-N
Fonte:
ISI
Lingua:
ENG
Soggetto:
RACIAL-DIFFERENCES; AFRICAN-AMERICAN; ANTIGEN LEVELS; BLACK-MEN; SURVIVAL; WHITE; AGE; CARCINOMA;
Keywords:
prostatic neoplasms; race; prognostic factors; prostatectomy; radiotherapy;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
17
Recensione:
Indirizzi per estratti:
Indirizzo: Kupelian, PA Cleveland Clin Fdn, Dept Radiat Oncol, 9500 Euclid Ave, Cleveland, OH 44195 USA Cleveland Clin Fdn 9500 Euclid Ave Cleveland OH USA 44195 USA
Citazione:
C.J. Sohayda et al., "Race as an independent predictor of outcome after treatment for localized prostate cancer", J UROL, 162(4), 1999, pp. 1331-1336

Abstract

Purpose: We analyze the outcome after prostatectomy or radiotherapy for localized prostate cancer with respect to race. Materials and Methods: A total of 2,219 consecutive patients with prostatecancer were treated with radiotherapy (1,183) or radical prostatectomy (1,036) between June 1986 and June 1998. Initial prostate specific antigen (PSA) and biopsy Gleason scores were available in all cases. Androgen deprivation was used in 22% of men (492). Of the patients 86% (1,901) were white, including Hispanic and Asian, and 14% (318) were black. The outcomes of interest were biochemical relapse-free survival, clinical relapse-free survivaland overall survival. Median followup was 24 months (range 2 to 140). Results: There was no difference in the incidence of familial prostate cancer, patient age at presentation, clinical stage or biopsy Gleason scores between black and white men. However, black men had higher initial PSA levels (median 13.3 versus 8.6 for white men, p <0.001). The 5-year biochemical relapse-free survival rate was 59% for the entire group, 54% (95% confidence interval 44 to 63) for black men and 61% (95% confidence interval 57 to 65) for white men (p = 0.11). Multivariate analysis was performed for the variables of age, race, family history of prostate cancer (brother or father), initial PSA, biopsy Gleason sum, clinical T stage, treatment modality andandrogen deprivation. Familial prostate cancer (p = 0.001), higher T stage(p <0.001), higher initial PSA (p <0.001), higher biopsy Gleason score (p <0.001) and use of androgen deprivation (p = 0.001) were independent predictors of biochemical failure and all other factors, including race, were not(p = 0.46). The projected 10-year clinical relapse-free survival rate was 74% for the entire group, and was identical for black and white men (p = 0.77). The projected 10-year overall survival rate for black and white men was 92 and 79%, respectively (p = 0.62). Conclusions: We have demonstrated a statistically nonsignificant trend forhigher biochemical failure rates in black men presenting with localized prostate cancer. This trend could be due to the higher pretreatment PSA levels in black patients. Treatment recommendations should not differ with respect to race.

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Documento generato il 06/04/20 alle ore 02:18:47