MP43-15 A 5-YEAR PROSPECTIVE STUDY OF AFRICAN AMERICAN MEN ON PROSTATE CANCER ACTIVE SURVEILLANCE: DOES RACE PREDICT UPGRADING?

Abstract

You have accessJournal of UrologyCME1 May 2022MP43-15 A 5-YEAR PROSPECTIVE STUDY OF AFRICAN AMERICAN MEN ON PROSTATE CANCER ACTIVE SURVEILLANCE: DOES RACE PREDICT UPGRADING? Joshua Pincus, Jacob W. Greenberg, Christopher Koller, Jonathan Silberstein, and L. Spencer Krane Joshua PincusJoshua Pincus More articles by this author , Jacob W. GreenbergJacob W. Greenberg More articles by this author , Christopher KollerChristopher Koller More articles by this author , Jonathan SilbersteinJonathan Silberstein More articles by this author , and L. Spencer KraneL. Spencer Krane More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002609.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Active surveillance (AS) is a widely accepted management option for patients with very low and low risk prostate cancer (PCa) to minimize side effects of treatment without compromise of disease mortality. However, most large single institution studies are underrepresented for men from African American (AA) heritage. In this large prospective cohort we hypothesized that race was not associated with Gleason upgrading (GU) for patients electing AS. METHODS: All patients who elected AS for PCa at the Southeast Louisiana Veterans Health Care System are entered into a prospectively managed observational database. Patients were divided into groups based on self-reported race. GU was defined as an increase in WHO grade group (GG) on subsequent biopsy over GG 1. All tests were two sided using a significance of 0.05. RESULTS: 228 men were enrolled in the study, including 154 AA and 74 CA men, with a median follow-up of 5 years from the initiation of AS. At the time of diagnostic biopsy, there was no significant difference with respect to age, family history of PCa, smoking status, PSA, PSA density, prostate volume, or number of positive cores (all P values > 0.05). AA race was not predictive of GU on Cox multivariate analysis (Table 1), with a hazard ratio (HR) of 1.02 and 95% CI of 0.65 - 1.61 (P = 0.92). Number of positive cores was correlated with GU (HR = 1.32, CI 1.17-1.48, P < 0.0001). On Kaplan-Meier analysis (Figure 1), the 2.5-year GU-Free survival probability was 71% for AA (CI 63% - 78%) and 72% for CA (CI 63% - 83%). At 5 years, AA GU-free survival probability was 48% (CI 40% - 58%) versus 58% for CA (CI 46% - 72%). Risk of GU was similar between races (p=0.35) at both 2.5 and 5 years with 47% of all patients remaining on AS or without local curative therapy. CONCLUSIONS: AS is a safe treatment option for low and very low risk PCa, regardless of race. AA and CA men did not have any significant difference in GU in our cohort with five-year follow up. Importantly, our study is conducted in an equal access setting and includes a large prospective cohort of AA patients on AS for PCa. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e747 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Joshua Pincus More articles by this author Jacob W. Greenberg More articles by this author Christopher Koller More articles by this author Jonathan Silberstein More articles by this author L. Spencer Krane More articles by this author Expand All Advertisement PDF DownloadLoading ...