Cancer Medicine (Nov 2022)

Race‐specific prostate cancer outcomes in a cohort of military health care beneficiaries undergoing surgery: 1990–2017

  • Nathan Oehrlein,
  • Samantha A. Streicher,
  • Huai‐Ching Kuo,
  • Avinash Chaurasia,
  • Jacob McFadden,
  • Darryl Nousome,
  • Yongmei Chen,
  • Sean P. Stroup,
  • John Musser,
  • Timothy Brand,
  • Christopher Porter,
  • Inger L. Rosner,
  • Gregory T. Chesnut,
  • Kayla C. Onofaro,
  • Timothy R. Rebbeck,
  • Anthony D’Amico,
  • Grace Lu‐Yao,
  • Jennifer Cullen

DOI
https://doi.org/10.1002/cam4.4787
Journal volume & issue
Vol. 11, no. 22
pp. 4354 – 4365

Abstract

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Abstract Background There is substantial variability in prostate cancer (PCa) mortality rates across Caucasian American (CA), African American (AA), Asian, and Hispanic men; however, these estimates are unable to disentangle race or ethnicity from confounding factors. The current study explores survival differences in long‐term PCa outcomes between self‐reported AA and CA men, and examines clinicopathologic features across self‐reported CA, AA, Asian, and Hispanic men. Methods This retrospective cohort study utilized the Center for Prostate Disease Research (CPDR) Multi‐center National Database from 1990 to 2017. Subjects were consented at military treatment facilities nationwide. AA, CA, Asian, or Hispanic men who underwent radical prostatectomy (RP) for localized PCa within the first year of diagnosis were included in the analyses. Time from RP to biochemical recurrence (BCR), BCR to metastasis, and metastasis to overall death were evaluated using Kaplan–Meier unadjusted estimation curves and adjusted Cox proportional hazards regression. Results This study included 7067 men, of whom 5155 (73%) were CA, 1468 (21%) were AA, 237 (3%) were Asian, and 207 (3%) were Hispanic. AA men had a significantly decreased time from RP to BCR compared to CA men (HR = 1.25, 95% CI = 1.06–1.48, p = 0.01); however, no difference was observed between AA and CA men for a time from BCR to metastasis (HR = 0.73, 95% CI = 0.39–1.33, p = 0.302) and time from metastasis to overall death (HR = 0.67, 95% CI = 0.36–1.26, p = 0.213). Conclusions In an equal access health care setting, AA men had a shorter survival time from RP to BCR, but comparable survival time from BCR to metastasis and metastasis to overall death.

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