Carcinoma of the prostate: race as a prognostic indicator in definitive radiation therapy.

Abstract

Black men have more aggressive prostatic tumors, a higher rate of metastasis, and a poorer survival rate than do white men.

Disease specific death after external beam radiation of prostate cancer

“…3 The present analysis extends these observations in demonstrating that the association of black race with lower disease-speci®c survival is prognostically informative individually of other variables, for example, grade, stage, time period of diagnosis. Because within clinical stage categories blacks have higher tumor volume than whites, 16 it is possible that the clinical stage is too gross a measure of disease to adjust the risk across race.…”

“…11 Potential partial explanations for varying outcomes by calendar time include variations in treated patient age, staging methods, and patterns of care, for example dissemination of external beam radiation in the early 1980s. 1,3,7,12 Regardless of whether or not calendar time effects are due to cohort effects, stages of diagnosis and treatment, patient selection, and/or technical modi®cations of treatments, they can signi®cantly confound efforts to estimate clinical outcomes and cannot be ignored. In generalizing the results of reports that group patients across many years, for example from 1956±1992, 1 one must be cautious.…”

Racial differences in allogeneic hematopoietic cell transplantation outcomes among African Americans and whites

“…[1][2][3][4][5][6][7] Several reasons have been suggested, including socieoeconomic and cultural factors, cancer biology, differential treatment intensity, pharmacogenetics and comorbid conditions. [8][9][10][11][12] Data from hematologic malignancies such as AML also demonstrate poorer survival and worse CR rates in African Americans, specifically men, compared with African American women and whites.…”

Prostate cancer in African American men

“…Aziz et al, 59 found that black radiated patients were more likely to have Gleason sum of 7±10 which corresponded to higher stage and lower survival but multivariate analysis was not performed. Similarly, Kim et al, 60 studied 489 white and 157 black irradiation patients ®nding that 40% of blacks vs 26.% of whites (P`0.001) had poorly differentiated tumors. Blacks had signi®cantly worse overall survival and even with stage strati®cation, blacks with stage C disease had a worse cause-speci®c survival.…”