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Urology. 2004 Aug;64(2):212-7.

Impact of race on survival in men with metastatic hormone-refractory prostate cancer.

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1
Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina 27710, USA.

Abstract

OBJECTIVES:

To determine whether blacks with hormone-refractory prostate cancer have shorter survival compared with whites with the same disease.

METHODS:

Data from eight multicenter trials (four Phase II and four randomized Phase III studies) conducted by the Cancer and Leukemia Group B were combined. Eligible patients had progressive prostate cancer after androgen deprivation therapy (with documented castration levels of testosterone), an Eastern Cooperative Oncology Group performance status of 0 to 2, and adequate hematologic, renal, and hepatic function. The proportional hazards model was used to assess the prognostic importance of race, adjusting for important factors. All statistical tests were two-sided.

RESULTS:

Of the 1183 patients, 15% were blacks, 45% of patients had a Gleason sum of 8 or greater, and the median age was 71 years. Of the 1183 patients, 35% had measurable disease and 89% had an Eastern Cooperative Oncology Group performance status of 0 to 1. Blacks were younger, had a shorter interval between diagnosis and study entry, and had greater prostate-specific antigen levels, lower hemoglobin levels, and a lower likelihood of prior prostatectomy than whites. The median survival was 15 months (95% confidence interval 12 to 18) for blacks compared with 14 months (95% confidence interval 13 to 15) for whites. In a multivariate analysis, adjusting for age, performance status, presence of visceral disease, hemoglobin, Gleason sum, prostate-specific antigen level, alkaline phosphatase, lactate dehydrogenase, and years since diagnosis, the hazard ratio was 0.85 (95% confidence interval 0.71 to 1.02, P = 0.08) for blacks compared with whites.

CONCLUSIONS:

No statistically significant difference was found in overall survival between blacks and whites with metastatic hormone-refractory prostate cancer.

PMID:
15302462
DOI:
10.1016/j.urology.2004.04.014
[Indexed for MEDLINE]
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