Prostate Cancer Grade and Stage Misclassification in Active Surveillance Candidates: Black Versus White Patients
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Prostate Cancer Grade and Stage Misclassification in Active Surveillance Candidates: Black Versus White Patients. / Stolzenbach, Lara Franziska; Rosiello, Giuseppe; Pecoraro, Angela; Palumbo, Carlotta; Luzzago, Stefano; Deuker, Marina; Tian, Zhe; Knipper, Anne-Sophie; Pompe, Raisa; Zorn, Kevin C; Shariat, Shahrokh F; Chun, Felix K H; Graefen, Markus; Saad, Fred; Karakiewicz, Pierre I.
In: J NATL COMPR CANC NE, Vol. 18, No. 11, 11.2020, p. 1492-1499.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Prostate Cancer Grade and Stage Misclassification in Active Surveillance Candidates: Black Versus White Patients
AU - Stolzenbach, Lara Franziska
AU - Rosiello, Giuseppe
AU - Pecoraro, Angela
AU - Palumbo, Carlotta
AU - Luzzago, Stefano
AU - Deuker, Marina
AU - Tian, Zhe
AU - Knipper, Anne-Sophie
AU - Pompe, Raisa
AU - Zorn, Kevin C
AU - Shariat, Shahrokh F
AU - Chun, Felix K H
AU - Graefen, Markus
AU - Saad, Fred
AU - Karakiewicz, Pierre I
PY - 2020/11
Y1 - 2020/11
N2 - BACKGROUND: Misclassification rates defined as upgrading, upstaging, and upgrading and/or upstaging have not been tested in contemporary Black patients relative to White patients who fulfilled criteria for very-low-risk, low-risk, or favorable intermediate-risk prostate cancer. This study aimed to address this void.METHODS: Within the SEER database (2010-2015), we focused on patients with very low, low, and favorable intermediate risk for prostate cancer who underwent radical prostatectomy and had available stage and grade information. Descriptive analyses, temporal trend analyses, and multivariate logistic regression analyses were used.RESULTS: Overall, 4,704 patients with very low risk (701 Black vs 4,003 White), 17,785 with low risk (2,696 Black vs 15,089 White), and 11,040 with favorable intermediate risk (1,693 Black vs 9,347 White) were identified. Rates of upgrading and/or upstaging in Black versus White patients were respectively 42.1% versus 37.7% (absolute Δ = +4.4%; P<.001) in those with very low risk, 48.6% versus 46.0% (absolute Δ = +2.6%; P<.001) in those with low risk, and 33.8% versus 35.3% (absolute Δ = -1.5%; P=.05) in those with favorable intermediate risk.CONCLUSIONS: Rates of misclassification were particularly elevated in patients with very low risk and low risk, regardless of race, and ranged from 33.8% to 48.6%. Recalibration of very-low-, low-, and, to a lesser extent, favorable intermediate-risk active surveillance criteria may be required. Finally, our data indicate that Black patients may be given the same consideration as White patients when active surveillance is an option. However, further validations should ideally follow.
AB - BACKGROUND: Misclassification rates defined as upgrading, upstaging, and upgrading and/or upstaging have not been tested in contemporary Black patients relative to White patients who fulfilled criteria for very-low-risk, low-risk, or favorable intermediate-risk prostate cancer. This study aimed to address this void.METHODS: Within the SEER database (2010-2015), we focused on patients with very low, low, and favorable intermediate risk for prostate cancer who underwent radical prostatectomy and had available stage and grade information. Descriptive analyses, temporal trend analyses, and multivariate logistic regression analyses were used.RESULTS: Overall, 4,704 patients with very low risk (701 Black vs 4,003 White), 17,785 with low risk (2,696 Black vs 15,089 White), and 11,040 with favorable intermediate risk (1,693 Black vs 9,347 White) were identified. Rates of upgrading and/or upstaging in Black versus White patients were respectively 42.1% versus 37.7% (absolute Δ = +4.4%; P<.001) in those with very low risk, 48.6% versus 46.0% (absolute Δ = +2.6%; P<.001) in those with low risk, and 33.8% versus 35.3% (absolute Δ = -1.5%; P=.05) in those with favorable intermediate risk.CONCLUSIONS: Rates of misclassification were particularly elevated in patients with very low risk and low risk, regardless of race, and ranged from 33.8% to 48.6%. Recalibration of very-low-, low-, and, to a lesser extent, favorable intermediate-risk active surveillance criteria may be required. Finally, our data indicate that Black patients may be given the same consideration as White patients when active surveillance is an option. However, further validations should ideally follow.
U2 - 10.6004/jnccn.2020.7580
DO - 10.6004/jnccn.2020.7580
M3 - SCORING: Journal article
C2 - 33152695
VL - 18
SP - 1492
EP - 1499
JO - J NATL COMPR CANC NE
JF - J NATL COMPR CANC NE
SN - 1540-1405
IS - 11
ER -
