Disease-free survival difference between African Americans and whites after radical prostatectomy for local prostate cancer

A multivariable analysis

Isaac J. Powell, Jyotirmoy Dey, Amanda Dudley, J. Edson Pontes, Michael L. Cher, Wael Sakr, David Grignon, David P. Wood

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Objectives. Age-adjusted mortality rates (per 100,000) for men with prostate cancer from 1991 through 1997 reported by the Surveillance, Epidemiology, and End Results national registry have consistently demonstrated that African-American men (AAM) have twice the death rate of white men (WM). However, there has been considerable controversy as to how this relates to progression-free survival among these men. In an attempt to address this controversy of localized prostate cancer, we report on a multivariable analysis of survival data of a large number of AAM and WM who underwent radical prostatectomy. Methods. The study cohort was composed of 791 men whose only prostate cancer treatment was radical prostatectomy performed between July 1990 and December 1999. The variables analyzed were age, preoperative prostate-specific antigen level, pathologic grade and stage, and race/ethnicity. Pathologic examination of all specimens was performed in a uniform manner according to an established protocol. Multivariable analysis based on Cox's proportional hazards regression model was performed to assess whether a significant difference in progression-free survival time between AAM and WM persisted after controlling for the main effects of other prognostic factors. Results. The study cohort consisted of 229 AAM and 562 WM. Our results indicated that all variables, except age, had highly significant effects on progression-free survival, even in the presence of other predictors. Conclusions. The effects of age, preoperative serum prostate-specific antigen level, and pathologic grade and stage did not account for the racial disparity in progression-free survival among men diagnosed with clinically localized prostate cancer and treated with radical prostatectomy.

Original languageEnglish (US)
Pages (from-to)907-912
Number of pages6
JournalUrology
Volume59
Issue number6
DOIs
StatePublished - 2002
Externally publishedYes

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Prostatectomy
African Americans
Disease-Free Survival
Prostatic Neoplasms
Prostate-Specific Antigen
Cohort Studies
Mortality
Survival Analysis
Proportional Hazards Models
Registries
Epidemiology

ASJC Scopus subject areas

  • Urology

Cite this

Disease-free survival difference between African Americans and whites after radical prostatectomy for local prostate cancer : A multivariable analysis. / Powell, Isaac J.; Dey, Jyotirmoy; Dudley, Amanda; Pontes, J. Edson; Cher, Michael L.; Sakr, Wael; Grignon, David; Wood, David P.

In: Urology, Vol. 59, No. 6, 2002, p. 907-912.

Research output: Contribution to journalArticle

Powell, Isaac J. ; Dey, Jyotirmoy ; Dudley, Amanda ; Pontes, J. Edson ; Cher, Michael L. ; Sakr, Wael ; Grignon, David ; Wood, David P. / Disease-free survival difference between African Americans and whites after radical prostatectomy for local prostate cancer : A multivariable analysis. In: Urology. 2002 ; Vol. 59, No. 6. pp. 907-912.
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AB - Objectives. Age-adjusted mortality rates (per 100,000) for men with prostate cancer from 1991 through 1997 reported by the Surveillance, Epidemiology, and End Results national registry have consistently demonstrated that African-American men (AAM) have twice the death rate of white men (WM). However, there has been considerable controversy as to how this relates to progression-free survival among these men. In an attempt to address this controversy of localized prostate cancer, we report on a multivariable analysis of survival data of a large number of AAM and WM who underwent radical prostatectomy. Methods. The study cohort was composed of 791 men whose only prostate cancer treatment was radical prostatectomy performed between July 1990 and December 1999. The variables analyzed were age, preoperative prostate-specific antigen level, pathologic grade and stage, and race/ethnicity. Pathologic examination of all specimens was performed in a uniform manner according to an established protocol. Multivariable analysis based on Cox's proportional hazards regression model was performed to assess whether a significant difference in progression-free survival time between AAM and WM persisted after controlling for the main effects of other prognostic factors. Results. The study cohort consisted of 229 AAM and 562 WM. Our results indicated that all variables, except age, had highly significant effects on progression-free survival, even in the presence of other predictors. Conclusions. The effects of age, preoperative serum prostate-specific antigen level, and pathologic grade and stage did not account for the racial disparity in progression-free survival among men diagnosed with clinically localized prostate cancer and treated with radical prostatectomy.

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