Trends in Disparate Treatment of African American Men With Localized Prostate Cancer Across National Comprehensive Cancer Network Risk Groups

Urology ◽  
2014 ◽  
Vol 84 (2) ◽  
pp. 386-392 ◽  
Author(s):  
Brandon A. Mahal ◽  
Ayal A. Aizer ◽  
David R. Ziehr ◽  
Andrew S. Hyatt ◽  
Jesse D. Sammon ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
African American ◽  
National Comprehensive Cancer Network ◽  
African American Men ◽  
Risk Groups ◽  
Localized Prostate Cancer ◽  
Disparate Treatment ◽  
Network Risk ◽  
Cancer Network

scholarly journals Receipt of National Comprehensive Cancer Network guideline-concordant prostate cancer care among African American and Caucasian American men in North Carolina

Cancer ◽  
2013 ◽  
Vol 119 (12) ◽  
pp. 2282-2290 ◽  
Author(s):  
Shellie D. Ellis ◽  
Bonny Blackard ◽  
William R. Carpenter ◽  
Merle Mishel ◽  
Ronald C. Chen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
North Carolina ◽  
African American ◽  
National Comprehensive Cancer Network ◽  
Cancer Care ◽  
Caucasian American ◽  
Cancer Network

Impact of Race on Prostate-Specific Antigen Outcome After Radical Prostatectomy for Clinically Localized Adenocarcinoma of the Prostate

2002 ◽  
Vol 20 (12) ◽  
pp. 2863-2868 ◽  
Author(s):  
Chaundre K. Cross ◽  
Delray Shultz ◽  
S. Bruce Malkowicz ◽  
William C. Huang ◽  
Richard Whittington ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
African American ◽  
High Risk ◽  
Gleason Score ◽  
Risk Group ◽  
African American Men ◽  
Specific Antigen ◽  
White Men ◽  
Risk Groups ◽  
T Stage

PURPOSE: To compare prostate-specific antigen (PSA) outcome after radical prostatectomy (RP) for prostate cancer in African-American and white men using previously established risk groups. PATIENTS AND METHODS: Between 1989 and 2000, 2,036 men (n = 162 African-American men, n = 1,874 white men) underwent RP for clinically localized prostate cancer. Using pretreatment PSA, Gleason score, clinical T stage, and percentage of positive biopsy specimens, patients were stratified into low- and high-risk groups. For each risk group, PSA outcome was estimated using the actuarial method of Kaplan and Meier. Comparisons of PSA outcome between African-American and white men were made using the log-rank test. RESULTS: The median age and PSA level for African-American and white men were 60 and 62 years old and 8.8 and 7.0 ng/mL, respectively. African-Americans had a statistically significant increase in PSA (P = .002), Gleason score (P = .003), clinical T stage (P = .004), and percentage of positive biopsy specimens (P = .04) at presentation. However, there was no statistical difference in the distribution of PSA, clinical T stage, or Gleason score between racial groups in the low- and high-risk groups. The 5-year estimate of PSA outcome was 87% in the low-risk group for all patients (P = .70) and 28% versus 32% in African-American and white patients in the high-risk group (P = .28), respectively. Longer follow-up is required to confirm if these results are maintained at 10 years. CONCLUSION: Even though African-American men presented at a younger age and with more advanced disease compared with white men with prostate cancer, PSA outcome after RP when controlled for known clinical predictive factors was not statistically different. This study supports earlier screening in African-American men.

Impact of primary Gleason grade 4 on biochemical recurrence after permanent interstitial brachytherapy in Japanese patients with low- or intermediate-risk prostate cancer.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 77-77
Author(s):  
T. Saika ◽  
T. Uesugi ◽  
K. Edamura ◽  
M. Kobuke ◽  
H. Nose ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
National Comprehensive Cancer Network ◽  
Biochemical Recurrence ◽  
Japanese Patients ◽  
Localized Prostate Cancer ◽  
Gleason Grade ◽  
Intermediate Risk ◽  
Nccn Guidelines ◽  
Cancer Network

77 Background: To reveal a predictive factor for biochemical recurrence (BCR) after permanent prostate brachytherapy (PPB) using iodine-125 (125I) seed implantation in patients with localized prostate cancer classified as low or intermediate risk based on the National Comprehensive Cancer Network (NCCN) guidelines. Methods: From January 2004 to December 2009, consecutive 418 Japanese patients with clinically localized prostate cancer classified as low or intermediate risk based on the National Comprehensive Cancer Network (NCCN) guidelines were treated by PPB. The clinical factors including pathological data reviewed by central pathologist and follow-up data were prospectively collected. Kaplan-Meier and Cox regression analyses were used to assess the factors associated with BCR. Results: Median follow-up was 36.0 months. The 2, 3, 4 and 5-year BCR free rates using Phoenix definition were 98.3%, 96.0%, 91.6% and 87.0% respectively. On univariate analysis, primary Gleason grade 4 in biopsy specimen was strong predicting factor (p<0.0001), while Gleason sum, age, initial PSA, initial PSA density, T stage and D90 were insignificant factors. Multivariate analysis indicated that primary Gleason grade 4 was most powerful prognostic factor associated with BCR (hazard ratio=10.101, 95% IC 3.080-33.126, p=0.0001). Conclusions: The primary Gleason grade 4 carried a worse BCR than the primary grade 3 in Gleason score 7 prostate cancer. Therefore, the indication for PPB in patients with Gleason sum 4+3 should deserve careful and thoughtful consideration. No significant financial relationships to disclose.

EZH2 expression and clinical outcome in African-American men with prostate cancer.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 81-81
Author(s):  
Vivek Narayan ◽  
Priti Lal ◽  
Charnita Zeigler-Johnson ◽  
S. Bruce Malkowicz ◽  
Timothy Rebbeck
Keyword(s):  
Prostate Cancer ◽  
African American ◽  
Clinical Outcome ◽  
Cox Regression ◽  
African American Men ◽  
Prognostic Significance ◽  
Potential Effect ◽  
Localized Prostate Cancer ◽  
Free Survival ◽  
Prognostic Utility

81 Background: Despite increasing recognition of molecular differences in prostate cancers from African-American men (AAM) and European-American men (EAM), the prognostic utility of novel tissue biomarkers in AAM remains poorly defined. Overexpression of the oncogenic transcriptional regulator EZH2 has been associated with clinical outcome in localized prostate cancer, but it has not been adequately evaluated in AAM. We sought to define the prognostic significance of EZH2 overexpression in a racially-balanced cohort of men with localized prostate cancer and to explore potential race-specific differences. Methods: This was a retrospective analysis of men who underwent radical prostatectomy at the University of Pennsylvania between 1991 and 2010. Subjects with formalin fixed paraffin embedded tissue available for EZH2 immunohistochemistry were included. Slides were graded in a semi-quantitative manner for both the volume and the intensity of EZH2 staining. Multivariate Cox regression models were used to evaluate the independent association of clinicopathologic parameters, including EZH2 staining index, and biochemical recurrence (BCR)-free survival. Results: 121 patients (62 AAM, 59 EAM) were eligible for analysis. 56 patients (46.3%) demonstrated EZH2 overexpression, which was balanced between AAM and EAM subgroups (43.6% vs 49.2%, respectively). Extracapsular extension, positive surgical margins, and EZH2 overexpression were independently associated with BCR-free survival (HR of 2.02 for EZH2 overexpression, 95% CI 1.05 – 3.86, p = 0.035). Potential effect modification by race was identified (p for interaction = 0.056). While EZH2 overexpression was independently associated with BCR-free survival in AAM (HR 2.78, 95% CI 1.06 – 7.32, p = 0.038), no significant association was identified in the EAM subset (HR 0.89, 95% CI 0.35 – 2.29, p = 0.812). Conclusions: EZH2 overexpression is a valid prognostic marker in AAM treated with prostatectomy. The potential for enhanced prognostic significance of EZH2 overexpression in AAM may lend insight into observed racial disparities. These results highlight the need for adequate representation of AAM in clinical trials evaluating novel EZH2-directed therapies.

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