MP4-04 CLINICAL OUTCOMES OF CONSERVATIVELY MANAGED PROSTATE CANCER AMONG AFRICAN AMERICAN MEN

Abstract

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History I1 Apr 2015MP4-04 CLINICAL OUTCOMES OF CONSERVATIVELY MANAGED PROSTATE CANCER AMONG AFRICAN AMERICAN MEN Amar Patel, Martin Sanda, Dattatraya Patil, Muta Issa, and John Petros Amar PatelAmar Patel More articles by this author , Martin SandaMartin Sanda More articles by this author , Dattatraya PatilDattatraya Patil More articles by this author , Muta IssaMuta Issa More articles by this author , and John PetrosJohn Petros More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.147AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Despite increasing utilization of non-intervention conservative care for prostate cancer (PCa), information about outcomes of conservative management among African American (AA) men is sparse. We sought to evaluate the outcomes of conservatively managed prostate cancer among African American men and their counterparts from other racial origin in the community-based, integrated care setting of the Atlanta VAMC. METHODS A prospective database of all patients undergoing prostate biopsy at the Atlanta VAMC from 2000 to 2013 was interrogated retrospectively to identify men diagnosed with PCa who were managed conservatively. Demographic, clinical, and histopathological factors were evaluated for association with endpoints including biochemical progression (index PSA <10 with subsequent rise to >10), histopathological progression (conversion from Gleason 6 or less to Gleason > 6), clinical progression (metastatic disease) and death. Statistical analysis was performed by univariate and multivariate measure of associations and/or time-to-event analyses as indicated. RESULTS There were 163 (6.6%) patients that had conservatively managed PCa. Median follow-up time was 10.9 months. There were a total of 71 (43.6%) patients with intermediate-risk disease and 9 (5.5%) with high-risk disease. The cohort consisted of 104 (63.8%) AA's of which, 45 (43.3%) had intermediate-risk disease and 8 (7.7%) with high-risk disease. 36/163 (22.1%) patients underwent repeat biopsy and 9/36 (25%) had histopathological progression. There was no significant difference in biochemical progression between AA and non-AA's (18.9% vs. 10.6%, p=0.22). Unexpectedly, non-AA's had a higher rate of clinical progression (8.5% vs. 1.0%, p= 0.02), which may be attributed to verification bias secondary to low number of repeat biopsies. There was no difference in deaths from PCa (2.9% vs. 1.7%, p=1.0) or time to biochemical progression (Log rank p = 0.39) among AA vs Non-AA's, respectively. Compared to indolent PCa, in patients with aggressive PCa (Gleason's score >=7) time to biochemical progression was significantly different between two racial groups (Log rank p=0.005) with Non-AA's progressing much rapidly than AA's. CONCLUSIONS To our knowledge, this is the first report focusing a PCa conservative care cohort comprised predominantly of AA men. Our findings suggest that clinical outcomes among AA are not substantially worse than those of men with other racial background. Validation of these findings in a prospective active surveillance study of AA patients with PCa is warranted. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e28 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Amar Patel More articles by this author Martin Sanda More articles by this author Dattatraya Patil More articles by this author Muta Issa More articles by this author John Petros More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...