Impact of race on survival in patients with clinically nonmetastatic prostate cancer who deferred primary treatment.
BACKGROUND
Prostate cancer (PCa) racial disparity studies typically focus on survival differences after curative treatment. The authors of this report hypothesized that comparing mortality rates between African American (AA) and Caucasian American (CA) patients who deferred primary treatment for clinically nonmetastatic PCa may provide a better assessment of the impact of race on the natural course of PCa.


METHODS
The pathology database of the New York Veterans Administration Medical Center (VAMC), an equal access-of-care facility, was searched for patients with biopsy-proven PCa. Inclusion criteria included 1) no evidence of metastatic disease or death within 3 years after diagnosis, 2) no primary treatment, and 3) a minimum of 5 years of follow-up for survivors.


RESULTS
In total, 518 patients met inclusion criteria between 1990 and 2005. AA patients were younger (P = .02) and had higher median prostate-specific antigen (PSA) levels (P = .001) at the time of diagnosis compared with CA patients. In a multivariate model, higher Gleason score and PSA level were associated with increased mortality (P = .001 and P = .03, respectively), but race was not a predictor of death from PCa.


CONCLUSIONS
The current data suggested that race did not have a major impact on survival in patients with PCa who deferred primary treatment for clinically nonmetastatic disease.
Department of Urology, New York University School of Medicine, New York, New York 10016, USA.
Michael
M
Koscuiszka
David
D
Hatcher
Paul J
PJ
Christos
Amy E
AE
Rose
Holly S
HS
Greenwald
Ya-lin
YL
Chiu
Samir S
SS
Taneja
Madhu
M
Mazumdar
Peng
P
Lee
Iman
I
Osman
D000367:Age Factors; D000368:Aged; D001706:Biopsy; D044383:Black People; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D010166:Palliative Care; D017430:Prostate-Specific Antigen; D011471:Prostatic Neoplasms / Q000208:ethnology* / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D012307:Risk Factors; D057832:Watchful Waiting / Q000379:methods; D044465:White People; D001741:Black or African American
D017430:Prostate-Specific Antigen