Racial/ethnic disparities in the distribution and effect of type and number of high-risk criteria on mortality in prostate cancer patients treated with radiotherapy
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Racial/ethnic disparities in the distribution and effect of type and number of high-risk criteria on mortality in prostate cancer patients treated with radiotherapy. / Chierigo, Francesco; Flammia, Rocco Simone; Sorce, Gabriele; Hoeh, Benedikt; Hohenhorst, Lukas; Panunzio, Andrea; Tian, Zhe; Saad, Fred; Graefen, Markus; Gallucci, Michele; Briganti, Alberto; Montorsi, Francesco; Chun, Felix K H; Shariat, Shahrokh F; Antonelli, Alessandro; Guano, Giovanni; Mantica, Guglielmo; Borghesi, Marco; Suardi, Nazareno; Terrone, Carlo; Karakiewicz, Pierre I.
In: ARAB J UROL, Vol. 21, No. 3, 2023, p. 135-141.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Racial/ethnic disparities in the distribution and effect of type and number of high-risk criteria on mortality in prostate cancer patients treated with radiotherapy
AU - Chierigo, Francesco
AU - Flammia, Rocco Simone
AU - Sorce, Gabriele
AU - Hoeh, Benedikt
AU - Hohenhorst, Lukas
AU - Panunzio, Andrea
AU - Tian, Zhe
AU - Saad, Fred
AU - Graefen, Markus
AU - Gallucci, Michele
AU - Briganti, Alberto
AU - Montorsi, Francesco
AU - Chun, Felix K H
AU - Shariat, Shahrokh F
AU - Antonelli, Alessandro
AU - Guano, Giovanni
AU - Mantica, Guglielmo
AU - Borghesi, Marco
AU - Suardi, Nazareno
AU - Terrone, Carlo
AU - Karakiewicz, Pierre I
N1 - © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2023
Y1 - 2023
N2 - OBJECTIVE: To assess differences in the distribution of type and number of D'Amico high-risk criteria (DHRCs) according to race/ethnicity (R/E) and their effect on cancer-specific mortality (CSM) in prostate cancer (PCa) patients treated with external beam radiotherapy (RT).METHODS: In the SEER database (2004-2016), we identified 31,002 PCa patients treated with RT with at least one DHRCs, namely PSA >20 ng/dL, biopsy Gleason Grade Group 4-5, and clinical T stage ≥T2c. Competing risks regression (CRR) model tested the association between DHRCs and 5-year CSM in all R/E subgroups.RESULTS: Of 31,002 patients, 20,894 (67%) were Caucasian, 5256 (17%) were African American, 2868 (9.3%) were Hispanic-Latino, and 1984 (6.4%) were Asian. The distributions of individual DHRCs and combinations of two DHRCs differed according to R/E, but not for the combination of three DHRCs. The effect related to the presence of a single DHRC, and combinations of two or three DHRCs on absolute CSM rates was lowest in Asians (1.2-6.8%), followed by in African Americans (2.3-12.2%) and Caucasians (2.3-12.1%), and highest in Hispanic/Latinos (1.7-13.8%). However, the opposite effect was observed in CRR, where hazard ratios were highest in Asians vs. other R/Es: Asians 1.00-2.59 vs. others 0.5-1.83 for one DHRC, Asians 3.4-4.75 vs. others 0.66-3.66 for two DHRCs, and Asians 7.22 vs. others 3.03-4.99 for all three DHRCs.CONCLUSIONS: R/E affects the proportions of DHRCs. Moreover, within the four examined R/E groups, the effect of DHRCs on absolute and relative CSM metrics also differed. Therefore, R/E-specific considerations may be warranted in high-risk PCa patients treated with RT.
AB - OBJECTIVE: To assess differences in the distribution of type and number of D'Amico high-risk criteria (DHRCs) according to race/ethnicity (R/E) and their effect on cancer-specific mortality (CSM) in prostate cancer (PCa) patients treated with external beam radiotherapy (RT).METHODS: In the SEER database (2004-2016), we identified 31,002 PCa patients treated with RT with at least one DHRCs, namely PSA >20 ng/dL, biopsy Gleason Grade Group 4-5, and clinical T stage ≥T2c. Competing risks regression (CRR) model tested the association between DHRCs and 5-year CSM in all R/E subgroups.RESULTS: Of 31,002 patients, 20,894 (67%) were Caucasian, 5256 (17%) were African American, 2868 (9.3%) were Hispanic-Latino, and 1984 (6.4%) were Asian. The distributions of individual DHRCs and combinations of two DHRCs differed according to R/E, but not for the combination of three DHRCs. The effect related to the presence of a single DHRC, and combinations of two or three DHRCs on absolute CSM rates was lowest in Asians (1.2-6.8%), followed by in African Americans (2.3-12.2%) and Caucasians (2.3-12.1%), and highest in Hispanic/Latinos (1.7-13.8%). However, the opposite effect was observed in CRR, where hazard ratios were highest in Asians vs. other R/Es: Asians 1.00-2.59 vs. others 0.5-1.83 for one DHRC, Asians 3.4-4.75 vs. others 0.66-3.66 for two DHRCs, and Asians 7.22 vs. others 3.03-4.99 for all three DHRCs.CONCLUSIONS: R/E affects the proportions of DHRCs. Moreover, within the four examined R/E groups, the effect of DHRCs on absolute and relative CSM metrics also differed. Therefore, R/E-specific considerations may be warranted in high-risk PCa patients treated with RT.
U2 - 10.1080/2090598X.2022.2148867
DO - 10.1080/2090598X.2022.2148867
M3 - SCORING: Journal article
C2 - 37521449
VL - 21
SP - 135
EP - 141
JO - ARAB J UROL
JF - ARAB J UROL
SN - 2090-598X
IS - 3
ER -