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Race is associated with discontinuation of active surveillance of low-risk prostate cancer: results from the Duke Prostate Center.

Publication ,  Journal Article
Abern, MR; Bassett, MR; Tsivian, M; Bañez, LL; Polascik, TJ; Ferrandino, MN; Robertson, CN; Freedland, SJ; Moul, JW
Published in: Prostate Cancer Prostatic Dis
March 2013

BACKGROUND: Active surveillance (AS) is increasingly utilized in low-risk prostate cancer (PC) patients. Although black race has traditionally been associated with adverse PC characteristics, its prognostic value for patients managed with AS is unclear. METHODS: A retrospective review identified 145 patients managed with AS at the Duke Prostate Center from January 2005 to September 2011. Race was patient-reported and categorized as black, white or other. Inclusion criteria included PSA <10 ng ml(-1), Gleason sum ≤ 6, and ≤ 33% of cores with cancer on diagnostic biopsy. The primary outcome was discontinuation of AS for treatment due to PC progression. In men who proceeded to treatment after AS, the trigger for treatment, follow-up PSA and biopsy characteristics were analyzed. Time to treatment was analyzed with univariable and multivariable Cox proportional hazards models and also stratified by race. RESULTS: In our AS cohort, 105 (72%) were white, 32 (22%) black and 8 (6%) another race. Median follow-up was 23.0 months, during which 23% percent of men proceeded to treatment. The demographic, clinical and follow-up characteristics did not differ by race. There was a trend toward more uninsured black men (15.6% black, 3.8% white, 0% other, P = 0.06). Black race was associated with treatment (hazard ratio (HR) 2.93, P = 0.01) as compared with white. When the analysis was adjusted for socioeconomic and clinical parameters at the time of PC diagnosis, black race remained the sole predictor of treatment (HR 3.08, P = 0.01). Among men undergoing treatment, the trigger was less often patient driven in black men (8 black, 33 white, 67% other, P = 0.05). CONCLUSIONS: Black race was associated with discontinuation of AS for treatment. This relationship persisted when adjusted for socioeconomic and clinical parameters.

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Published In

Prostate Cancer Prostatic Dis

DOI

EISSN

1476-5608

Publication Date

March 2013

Volume

16

Issue

1

Start / End Page

85 / 90

Location

England

Related Subject Headings

  • White People
  • Watchful Waiting
  • Urology & Nephrology
  • Retrospective Studies
  • Prostatic Neoplasms
  • Middle Aged
  • Male
  • Humans
  • Disease Progression
  • Black People
 

Citation

APA
Chicago
ICMJE
MLA
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Abern, M. R., Bassett, M. R., Tsivian, M., Bañez, L. L., Polascik, T. J., Ferrandino, M. N., … Moul, J. W. (2013). Race is associated with discontinuation of active surveillance of low-risk prostate cancer: results from the Duke Prostate Center. Prostate Cancer Prostatic Dis, 16(1), 85–90. https://doi.org/10.1038/pcan.2012.38
Abern, M. R., M. R. Bassett, M. Tsivian, L. L. Bañez, T. J. Polascik, M. N. Ferrandino, C. N. Robertson, S. J. Freedland, and J. W. Moul. “Race is associated with discontinuation of active surveillance of low-risk prostate cancer: results from the Duke Prostate Center.Prostate Cancer Prostatic Dis 16, no. 1 (March 2013): 85–90. https://doi.org/10.1038/pcan.2012.38.
Abern MR, Bassett MR, Tsivian M, Bañez LL, Polascik TJ, Ferrandino MN, et al. Race is associated with discontinuation of active surveillance of low-risk prostate cancer: results from the Duke Prostate Center. Prostate Cancer Prostatic Dis. 2013 Mar;16(1):85–90.
Abern, M. R., et al. “Race is associated with discontinuation of active surveillance of low-risk prostate cancer: results from the Duke Prostate Center.Prostate Cancer Prostatic Dis, vol. 16, no. 1, Mar. 2013, pp. 85–90. Pubmed, doi:10.1038/pcan.2012.38.
Abern MR, Bassett MR, Tsivian M, Bañez LL, Polascik TJ, Ferrandino MN, Robertson CN, Freedland SJ, Moul JW. Race is associated with discontinuation of active surveillance of low-risk prostate cancer: results from the Duke Prostate Center. Prostate Cancer Prostatic Dis. 2013 Mar;16(1):85–90.

Published In

Prostate Cancer Prostatic Dis

DOI

EISSN

1476-5608

Publication Date

March 2013

Volume

16

Issue

1

Start / End Page

85 / 90

Location

England

Related Subject Headings

  • White People
  • Watchful Waiting
  • Urology & Nephrology
  • Retrospective Studies
  • Prostatic Neoplasms
  • Middle Aged
  • Male
  • Humans
  • Disease Progression
  • Black People