title: Racial/ethnic differences in receipt of pelvic lymph node dissection among men with localized/regional prostate cancer.
abstract: BACKGROUND
  Black and Hispanic men have a lower prostate cancer (PCa) survival rate than white men. This racial/ethnic survival gap has been explained in part by differences in tumor characteristics, stage at diagnosis, and disparities in receipt of definitive treatment. Another potential contributing factor is racial/ethnic differences in the timely and accurate detection of lymph node metastases. The current study was conducted to examine the association between race/ethnicity and the receipt of pelvic lymph node dissection (PLND) among men with localized/regional PCa.
  
  
  METHODS
  Logistic regression was used to estimate the adjusted odds of undergoing PLND among men who were diagnosed during 2000 to 2002 with PCa, who underwent radical prostatectomy or PLND without radical prostatectomy, and who were diagnosed in regions covered by the Surveillance, Epidemiology, and End Results database (n = 40,848).
  
  
  RESULTS
  Black men were less likely to undergo PLND than white men (odds ratio [OR], 0.91; 95% confidence interval [CI], 0.84-0.98). When the analysis was stratified by PCa grade, black men with well differentiated PCa (OR, 0.48; 95% CI, 0.27-0.84) and poorly differentiated PCa (OR, 0.73; 95% CI, 0.60-0.89) were less likely to undergo PLND than their white counterparts, but racial differences were not observed among men with moderately differentiated PCa (OR, 0.96; 95% CI, 0.88-1.05).
  
  
  CONCLUSIONS
  Among men with poorly differentiated PCa, failure to undergo PLND was associated with worse survival. Racial disparities in the receipt of PLND, especially among men with poorly differentiated PCa, may contribute to racial differences in prostate cancer survival.
authors: Department of Urology, Roswell Park Cancer Institute, Buffalo, New York, USA.
authors: Matthew H
authors: MH
authors: Hayn
authors: Heather
authors: H
authors: Orom
authors: Vickie L
authors: VL
authors: Shavers
authors: Martin G
authors: MG
authors: Sanda
authors: Mark
authors: M
authors: Glasgow
authors: James L
authors: JL
authors: Mohler
authors: Willie
authors: W
authors: Underwood
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D054625:Healthcare Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008197:Lymph Node Excision / Q000706:statistics & numerical data*; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010388:Pelvis; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000208:ethnology* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018426:SEER Program; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*