PURPOSE: To assess the effect of race/ethnicity in cancer-specific mortality (CSM) adjusted for other-cause mortality (OCM) in metastatic prostate cancer patients (mPCa) treated with external beam radiotherapy (EBRT) to the prostate. METHODS: We relied on the Surveillance, Epidemiology, and End Results (SEER) database to identify Caucasian, African-American, Hispanic/Latino and Asian mPCa patients treated by EBRT between 2004 and 2016. Cumulative incidence plots displayed CSM after adjustment for OCM according to race/ethnicity. Propensity score matching accounted for patient age, prostate-specific antigen, clinical T and N stages, Gleason Grade Groups and M1 substages. OCM adjusted multivariable analyses tested for differences in CSM in African-Americans, Hispanic/Latinos and Asians relative to Cauacasians. RESULTS: After 3:1 propensity score matching and OCM adjustment, Asians exhibited lower CSM at 60 and 120 months (48.2 and 60.0%, respectively) compared to Caucasians (66.7 and 79.4%, respectively, p < 0.001). In OCM adjusted multivariable analyses, Asian race/ethnicity was associated with lower CSM (HR 0.66, CI 0.52-0.83, p < 0.001). Conversely, African-American and Hispanic/Latino race/ethnicity did not affect CSM. OCM rates were comparable between examined races/ethnicities. CONCLUSION: In the setting of mPCa treated with EBRT, Asians exhibit lower CSM than Caucasians, African-Americans and Hispanic/Latinos. This observation may warrant consideration in prognostic stratification schemes for newly diagnosed mPCa patients.

Cancer Prognostics and Health Outcomes Unit Division of Urology University of Montréal Health Center Montréal QC Canada

Department of Neurosciences Reproductive Sciences and Odontostomatology University of Naples Federico 2 Naples Italy

Department of Urology 2nd Faculty of Medicine Charles University Prague Czech Republic

Department of Urology and Division of Experimental Oncology URI Urological Research Institute IRCCS San Raffaele Scientific Institute Milan Italy

Department of Urology Comprehensive Cancer Center Medical University of Vienna Vienna Austria

Department of Urology University Hospital Frankfurt Frankfurt am Main Germany

Department of Urology University Hospital Hamburg Eppendorf Hamburg Germany

Department of Urology University of Texas Southwestern Dallas TX USA

Departments of Urology Weill Cornell Medical College New York NY USA

Division of Urology Department of Special Surgery Jordan University Hospital The University of Jordan Amman Jordan

Institute for Urology and Reproductive Health 1 M Sechenov 1st Moscow State Medical University Moscow Russia

Martini Klinik Prostate Cancer Center University Hospital Hamburg Eppendorf Martinistraße 52 20246 Hamburg Germany

World J Urol. 2022 Apr;40(4):1065. doi: 10.1007/s00345-021-03859-3 PubMed

Zobrazit více v PubMed

Wu JN, Fish KM, Evans CP, et al. No improvement noted in overall or cause-specific survival for men presenting with metastatic prostate cancer over a 20-year period. Cancer. 2014;120(6):818–823. doi: 10.1002/cncr.28485. PubMed DOI

Mottet N, van den Bergh RCN, Briers E et al (2021) EAU-ESTRO-ESUR-SIOG Guidelines on Prostate Cancer 2020 Edition. http://uroweb.org/guideline/prostate-cancer/LK—Prostate Cancer Uroweb. Accessed 23 Jan 2021

Parker CC, James ND, Brawley CD, et al. Radiotherapy to the primary tumour for newly diagnosed, metastatic prostate cancer (STAMPEDE): a randomised controlled phase 3 trial. Lancet. 2018;392(10162):2353–2366. doi: 10.1016/S0140-6736(18)32486-3. PubMed DOI PMC

Davis ID, Martin AJ, Stockler MR, et al. Enzalutamide with standard first-line therapy in metastatic prostate cancer. N Engl J Med. 2019;381(2):121–131. doi: 10.1056/NEJMoa1903835. PubMed DOI

Chi KN, Agarwal N, Bjartell A, et al. Apalutamide for metastatic, castration-sensitive prostate cancer. N Engl J Med. 2019;381(1):13–24. doi: 10.1056/NEJMoa1903307. PubMed DOI

Sweeney CJ, Chen Y-H, Carducci M, et al. Chemohormonal therapy in metastatic hormone-sensitive prostate cancer. N Engl J Med. 2015;373(8):737–746. doi: 10.1056/NEJMoa1503747. PubMed DOI PMC

Stolzenbach LF, Deuker M, Collà-Ruvolo C et al (2020) External beam radiation therapy improves survival in low-volume metastatic prostate cancer patients: a North American population-based study. Prostate Cancer Prostatic Dis PubMed

Bernard B, Muralidhar V, Chen Y-H, et al. Impact of ethnicity on the outcome of men with metastatic, hormone-sensitive prostate cancer. Cancer. 2017;123(9):1536–1544. doi: 10.1002/cncr.30503. PubMed DOI PMC

Ha Chung B, Horie S, Chiong E. The incidence, mortality, and risk factors of prostate cancer in Asian men. Prostate Int. 2019;7(1):1–8. doi: 10.1016/j.prnil.2018.11.001. PubMed DOI PMC

Stolzenbach LF, Rosiello G, Deuker M et al (2020) The impact of race and age on distribution of metastases in patients with prostate cancer. J Urol PubMed

Edge SB, Compton CC (2010) The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol 17(6):1471–1474 PubMed

Lughezzani G, Sun M, Shariat SF, et al. A population-based competing-risks analysis of the survival of patients treated with radical cystectomy for bladder cancer. Cancer. 2011;117(1):103–109. doi: 10.1002/cncr.25345. PubMed DOI

R Core Team (2013) R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. http://www.r-project.org/. Accessed 23 Jan 2021

Deuker M, Stolzenbach LF, Pecoraro A et al (2020) PSA, stage, grade and prostate cancer specific mortality in Asian American patients relative to Caucasians according to the United States Census Bureau race definitions. World J Urol PubMed PMC

Smith ZL, Eggener SE, Murphy AB. African-American prostate cancer disparities. Curr Urol Rep. 2017;18(10):81. doi: 10.1007/s11934-017-0724-5. PubMed DOI

Mahal BA, Chen Y-W, Muralidhar V, et al. Racial disparities in prostate cancer outcome among prostate-specific antigen screening eligible populations in the United States. Ann Oncol. 2017;28(5):1098–1104. doi: 10.1093/annonc/mdx041. PubMed DOI

Koochekpour S, Buckles E, Shourideh M, et al. Androgen receptor mutations and polymorphisms in african american prostate cancer. Int J Biol Sci. 2014;10(6):643–651. doi: 10.7150/ijbs.8974. PubMed DOI PMC

Dess RT, Hartman HE, Mahal BA, et al. Association of black race with prostate cancer-specific and other-cause mortality. JAMA Oncol. 2019;5(7):975. doi: 10.1001/jamaoncol.2019.0826. PubMed DOI PMC

Dobbs RW, Malhotra NR, Abern MR, et al. Prostate cancer disparities in Hispanics by country of origin: a nationwide population-based analysis. Prostate Cancer Prostat Dis. 2019;22(1):159–167. doi: 10.1038/s41391-018-0097-y. PubMed DOI

Racial/ethnic disparities in the distribution and effect of type and number of high-risk criteria on mortality in prostate cancer patients treated with radiotherapy

The effect of race/ethnicity on cancer-specific mortality after salvage radical prostatectomy