Do Hispanic Men Have Worse Outcomes After Radical Prostatectomy? Results From SEARCH

Urology. 2021 Mar:149:181-186. doi: 10.1016/j.urology.2020.10.043. Epub 2020 Nov 12.

Abstract

Objective: To examine the associations between ethnicity and outcomes after radical prostatectomy (RP) among Hispanics. While non-Hispanic Black men have worse prostate cancer (PC) outcomes, there are limited data on outcomes of Hispanic men, especially after RP.

Methods: We identified 3789 White men who underwent RP between 1988 and 2017 in the Shared Equal Access Regional Cancer Hospital database. Men were categorized as Hispanic or non-Hispanic. Logistic regression was used to test the association between ethnicity and PC adverse features. Cox models were used to test the association between ethnicity and biochemical recurrence (BCR), metastases, and castration-resistant PC (CRPC). All models were adjusted for age, prostate-specific antigen, clinical stage, biopsy grade group, surgery year, and surgical center.

Results: Of 3789 White men, 236 (6%) were Hispanic. Hispanic men had higher prostate-specific antigen, but all other characteristics were similar between ethnicities. On multivariable analysis, there was no difference between ethnicities in odds of extracapsular extension, seminal vesicle invasion, positive margins, positive lymph nodes, or high-grade disease (odds ratio 0.62-0.89, all P > .07). A total of 1168 men had BCR, 182 developed metastasis, and 132 developed CRPC. There was no significant association between Hispanic ethnicity and risk of BCR, metastases, or CRPC (hazards ratio 0.39-0.85, all P > .06).

Conclusion: In an equal access setting, we found no evidence Hispanic White men undergoing RP had worse outcomes than non-Hispanic White men. In fact, all hazard ratios were <1 and although they did not achieve statistical significance, suggest perhaps slightly better outcomes for Hispanic men. Larger studies are needed to confirm findings.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Black People / statistics & numerical data
  • Black or African American
  • Follow-Up Studies
  • Hispanic or Latino / statistics & numerical data*
  • Humans
  • Kallikreins / blood
  • Kaplan-Meier Estimate
  • Male
  • Margins of Excision
  • Middle Aged
  • Neoplasm Recurrence, Local / blood
  • Neoplasm Recurrence, Local / diagnosis
  • Neoplasm Recurrence, Local / epidemiology*
  • Neoplasm Recurrence, Local / prevention & control
  • Prostate-Specific Antigen / blood
  • Prostatectomy / statistics & numerical data*
  • Prostatic Neoplasms / blood
  • Prostatic Neoplasms / diagnosis
  • Prostatic Neoplasms / mortality
  • Prostatic Neoplasms / surgery*
  • Retrospective Studies
  • United States / epidemiology
  • White People / statistics & numerical data

Substances

  • KLK3 protein, human
  • Kallikreins
  • Prostate-Specific Antigen