Select black men are potential candidates for prostate hemi-ablation based on radical prostatectomy histopathology for intermediate-risk prostate cancer—a multicenter SEARCH cohort study

Partial gland ablation (PGA) is increasingly popular as a treatment for men with intermediate-risk prostate cancer (IR-PCa) to preserve functional outcomes while controlling their cancer. We aimed to determine the impact of race and clinical characteristics on the risk of upstaging (≥pT2c) and havin...

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Published in:Prostate cancer and prostatic diseases 2024-08
Main Authors: Deivasigamani, Sriram, Adams, Eric S., Stock, Shannon, Kotamarti, Srinath, Séguier, Denis, Taha, Tarek, Howard, Lauren E., Aminsharifi, Alireza, Jibara, Ghalib, Amling, Christopher L., Aronson, William J., Cooperberg, Matthew R., Kane, Christopher J., Terris, Martha K., Klaassen, Zachary, Guerrios-Rivera, Lourdes, Freedland, Stephen J., Polascik, Thomas J.
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Language:English
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Summary:Partial gland ablation (PGA) is increasingly popular as a treatment for men with intermediate-risk prostate cancer (IR-PCa) to preserve functional outcomes while controlling their cancer. We aimed to determine the impact of race and clinical characteristics on the risk of upstaging (≥pT2c) and having adverse pathological outcomes including seminal vesicle invasion (SVI), extra prostatic extension (EPE) and lymph node invasion (LNI) at radical prostatectomy (RP) among men with IR disease eligible for PGA with hemi-ablation (HA).IMPORTANCE AND OBJECTIVEPartial gland ablation (PGA) is increasingly popular as a treatment for men with intermediate-risk prostate cancer (IR-PCa) to preserve functional outcomes while controlling their cancer. We aimed to determine the impact of race and clinical characteristics on the risk of upstaging (≥pT2c) and having adverse pathological outcomes including seminal vesicle invasion (SVI), extra prostatic extension (EPE) and lymph node invasion (LNI) at radical prostatectomy (RP) among men with IR disease eligible for PGA with hemi-ablation (HA).Retrospective analysis.DESIGNRetrospective analysis.Multicenter.SETTINGMulticenter.We studied patients diagnosed with unilateral IR-PCa treated with RP between 1988 and 2020 at 9 different Veterans Affairs hospitals within the SEARCH cohort. We analyzed differences in clinicopathological characteristics and outcome variables (odds of ≥pT2c and SVI, EPE and LNI) by race using multivariable logistic regression after adjusting for covariates.PARTICIPANTS AND MEASURESWe studied patients diagnosed with unilateral IR-PCa treated with RP between 1988 and 2020 at 9 different Veterans Affairs hospitals within the SEARCH cohort. We analyzed differences in clinicopathological characteristics and outcome variables (odds of ≥pT2c and SVI, EPE and LNI) by race using multivariable logistic regression after adjusting for covariates.Among 3127 patients, 33% were African American (AA) men with unilateral IR-PCa undergoing RP. Compared to non-AA men, AA individuals were younger (61 vs. 65 years, p 
ISSN:1365-7852
1476-5608
1476-5608
DOI:10.1038/s41391-024-00880-6