Substantial Gleason reclassification in Black men with national comprehensive cancer network low-risk prostate cancer - A propensity score analysis

Emerging evidence suggests that a subset of Black men with National Comprehensive Cancer Network (NCCN) low-risk prostate cancer (PCa) may harbor high volume and genomically aggressive disease. However, limited, and ambiguous research exist to evaluate the risk of extreme Gleason reclassification in...

Full description

Saved in:
Bibliographic Details
Published in:Prostate cancer and prostatic diseases 2022-09, Vol.25 (3), p.547-552
Main Authors: Awasthi, Shivanshu, Mahal, Brandon A, Park, Jong Y, Creed, Jordan H, Williams, Vonetta L, Elkenawi, Asmaa, Meadows, Sylvester O, Pow-Sang, Julio M, Lu-Yao, Grace, Kelly, Wm Kevin, Lang, Damaris-Lois Y, Zgibor, Janice, Rebbeck, Timothy R, Yamoah, Kosj
Format: Article
Language:English
Subjects:
Black People
Cancer surgery
Health risks
Humans
Linear functions
Male
Neoplasm Grading
Patients
Poisson density functions
Propensity Score
Prostate cancer
Prostate-Specific Antigen
Prostatectomy
Prostatic Neoplasms - ethnology
Prostatic Neoplasms - pathology
Race
Reclassification
Regression models
Retrospective Studies
Risk
Statistical analysis
Urological surgery
White people
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Emerging evidence suggests that a subset of Black men with National Comprehensive Cancer Network (NCCN) low-risk prostate cancer (PCa) may harbor high volume and genomically aggressive disease. However, limited, and ambiguous research exist to evaluate the risk of extreme Gleason reclassification in Black men with low-risk PCa. This retrospective cohort study included 45,674 low-risk PCa patients who underwent prostatectomy and were not on active surveillance, from National Cancer Database (NCDB). A propensity score matched-pair design was employed, and the final cohort was limited to 1:1 matched 12,340 patients. Gleason score reclassification was used as primary endpoint. As such, any migration to pathologic Gleason score ≥7(3 + 4) was identified as overall, whereas migration to ≥7(4 + 3) was defined as extreme reclassification. A conditional Poisson regression model was used to estimate the risk of reclassification. Whereas spline model was used to estimate the impact of increasing time to treatment as a non-linear function on Gleason reclassification between race group. Upon matching there were no differences in the baseline characteristics between race groups. In a matched cohort, higher proportion of low-risk Black men (6.6%) reported extreme reclassification to pathologic Gleason score than White men (5.0%), p 
ISSN:1365-7852
1476-5608
DOI:10.1038/s41391-022-00510-z