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Comparative Study
. 2022 Jan;54(1):81-87.
doi: 10.1007/s11255-021-03055-7. Epub 2021 Nov 16.

Cancer-specific mortality after radical prostatectomy vs external beam radiotherapy in high-risk Hispanic/Latino prostate cancer patients

Benedikt Hoeh  1   2 , Jan L Hohenhorst  3   4 , Rocco Flammia  3   5 , Benedikt Horlemann  3 , Gabriele Sorce  3   6 , Francesco Chierigo  3   7 , Zhe Tian  3 , Fred Saad  3 , Markus Graefen  4 , Michele Gallucci  5 , Alberto Briganti  6 , Carlo Terrone  7 , Shahrokh F Shariat  8   9   10   11   12   13 , Luis A Kluth  14 , Andreas Becker  14 , Felix K H Chun  14 , Pierre I Karakiewicz  3
Affiliations
Comparative Study

Cancer-specific mortality after radical prostatectomy vs external beam radiotherapy in high-risk Hispanic/Latino prostate cancer patients

Benedikt Hoeh et al. Int Urol Nephrol. 2022 Jan.

Abstract

Purpose: To test for differences in cancer-specific mortality (CSM) rates in Hispanic/Latino prostate cancer patients according to treatment type, radical prostatectomy (RP) vs external beam radiotherapy (EBRT).

Methods: Within the Surveillance, Epidemiology, and End Results database (2010-2016), we identified 2290 NCCN (National Comprehensive Cancer Network) high-risk (HR) Hispanic/Latino prostate cancer patients. Of those, 893 (39.0%) were treated with RP vs 1397 (61.0%) with EBRT. First, cumulative incidence plots and competing risks regression models tested for CSM differences after adjustment for other cause mortality (OCM). Second, cumulative incidence plots and competing risks regression models were refitted after 1:1 propensity score matching (according to age, PSA, biopsy Gleason score, cT-stage, cN-stage).

Results: In NCCN HR patients, 5-year CSM rates for RP vs EBRT were 2.4 vs 4.7%, yielding a multivariable hazard ratio of 0.37 (95% CI 0.19-0.73, p = 0.004) favoring RP. However, after propensity score matching, the hazard ratio of 0.54 was no longer statistically significant (95% CI 0.21-1.39, p = 0.2).

Conclusion: Without the use of strictest adjustment for population differences, NCCN high-risk Hispanic/Latino prostate cancer patients appear to benefit more of RP than EBRT. However, after strictest adjustment for baseline patient and tumor characteristics between RP and EBRT cohorts, the apparent CSM benefit of RP is no longer statistically significant. In consequence, in Hispanic/Latino NCCN high-risk patients, either treatment modality results in similar CSM outcome.

Keywords: Cancer-specific survival; External beam radiotherapy; High-risk prostate cancer; Hispanic–Latino race/ethnicity; Radical prostatectomy.

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Conflict of interest statement

The authors declare that there is no conflict of interests.

Figures

Fig. 1
Fig. 1
Cumulative incidence plots depicting cancer-specific mortality (CSM) after adjustment for other cause mortality (OCM) in radical prostatectomy vs external beam radiotherapy NCCN high-risk Hispanic/Latino prostate cancer patients. HR hazard ratio, CI 95%-confidence interval, NCCN National Comprehensive Cancer Network
Fig. 2
Fig. 2
Cumulative incidence plots after 1:1 propensity score matching depicting cancer-specific mortality (CSM) after adjustment for other cause mortality (OCM) in radical prostatectomy (RP) vs external beam radiotherapy (EBRT) NCCN high-risk Hispanic/Latino prostate cancer patients. HR hazard ratio, CI 95%-confidence interval, NCCN National Comprehensive Cancer Network
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