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Prostate Cancer: Localized: Surgical Therapy III (MP50): Moderated Poster 50: Sunday, September 12, 2021

MP50-14 THE IMPACT OF RACE/ETHNICITY ON UPSTAGING AND/OR UPGRADING RATES AMONG INTEREDIATE RISK PROSTATE CANCER PATIENTS TREATED WITH RADICAL PROSTATECTOMY

Nocera, Luigi; Wenzel, Mike; Ruvolo, Claudia Collà; Wurnschimmel, Christoph; Tian, Zhe; Gandaglia, Giorgio; Fossati, Nicola; Pellegrino, Francesco; Sorce, Gabriele; Leni, Riccardo; Robesti, Daniele; Cannoletta, Donato; Chun, Felix; Mirone, Vincenzo; Graefen, Markus; Saad, Fred; Shariat, Shahrokh; Montorsi, Francesco; Briganti, Alberto; Karakiewicz, Pierre

doi: 10.1097/JU.0000000000002076.14
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INTRODUCTION AND OBJECTIVE:

Race/ethnicity may predispose to less favorable prostate cancer characteristics in intermediate risk prostate cancer (IR PCa) patients. We tested this hypothesis in a subgroup of IR PCa patients treated with radical prostatectomy (RP).

METHODS:

We relied on the Surveillance, Epidemiology and End Results 2004-2016. The effect of race/ethnicity was tested in univariable and multivariable logistic regression analyses predicting upstaging (pT3+/pN1) and/or upgrading (Gleason Grade Group [GGG] 4-5) at RP.

RESULTS:

Of 20,391 IR PCa patients, 15,050 (73.8%) were Caucasian, 2,857 (14.0%) African-American, 1,632 (8.0%) Hispanic/Latino and 852 (4.2%) Asian. Asian patients exhibited highest age (64 year), highest PSA (6.8 ng/ml) and highest rate of GGG3 (31.9%). African-Americans exhibited the highest percentage of positive cores at biopsy (41.7%) and the highest proportion of NCCN unfavorable risk group membership (54.6%). Conversely, Caucasians exhibited the highest proportion of cT2 stage (35.6%). In univariable analyses, Hispanic/Latinos exhibited the highest rates of upstaging/upgrading among all race/ethnicities, in both favorable and unfavorable groups, followed by Asians, Caucasians and African-Americans in that order. In multivariable analyses, Hispanic/Latino race/ethnicity represented an independent predictor of higher upstaging and/or upgrading in favorable IR PCa (Odds Ratio [OR] 1.27, p<0.01), while African-American race/ethnicity represented an independent predictor of lower upstaging and/or upgrading in unfavorable IR PCa (OR 0.79, p<0.001).

CONCLUSIONS:

Race/ethnicity predisposes to differences in clinical, as well as in pathological characteristics in IR PCa patients. Specifically, even after full statistical adjustment, Hispanic/Latinos are at higher and African-Americans are at lower risk of upstaging and/or upgrading.

Source of Funding:

None

© 2021 by American Urological Association Education and Research, Inc.