African-American (AA) men have the greatest incidence of and disease-specific mortality from prostate cancer of any racial group. Although encouraging oncologic and functional outcomes have been reported with prostate cancer cryotherapy, little is known about how ethnicity can potentially affect the oncologic outcomes of primary cryotherapy. We report the oncologic outcomes of primary cryotherapy in AA patients through a matched-pair analysis.
A 1:2 (AA to non-AA) cohort of patients was designed using the Cryo-On-Line Data Registry. The 2 arms were matched for patient age, prostate-specific antigen level, Gleason score, and prostate volume. The oncologic outcome was defined in terms of the biochemical recurrence (BCR) rates after primary cryoablation using Phoenix criteria. The results of "for-cause" post-treatment biopsies and the BCR-free survival rates were also analyzed between the 2 groups.
The 1:2 cohort of AA and non-AA men in the present study included 109 and 218 men, respectively. Their median age (69 vs. 71 years; P = .71), median prostate-specific antigen level (6.5 vs. 6.8 ng/mL; P = .95), median prostate volume (32 vs. 30 cm3; P = .31), Gleason score distribution (P = .97), and prostate cancer risk group (P = .12) were similar statistically. The median postoperative follow-up period was also comparable between the 2 groups (AA, 32 months vs. non-AA, 27 months; P = .52). The BCR rates were similar between the AA and non-AA men (14% vs. 17%; P = .52). Likewise, the rate of positive "for-cause" prostate biopsy findings was similar between the 2 groups (AA vs. non-AA, 25% vs. 36%; P = .44). Furthermore, the 5-year biochemical relapse-free survival rates were comparable for the AA and non-AA patients (74% vs. 71%; P = .37).
When matched for tumor characteristics, cryotherapy as a treatment modality for primary, clinically localized prostate cancer offers men of African-American descent similar oncologic outcomes to those of non-AA men.
Clinical genitourinary cancer. 2018 Jul 06 [Epub ahead of print]
Alireza Aminsharifi, Thomas J Polascik, Matvey Tsivian, Ariel Schulman, Efrat Tsivian, Kae Jack Tay, Ahmed Elshafei, J Stephen Jones
Division of Urology, Duke Cancer Institute, Durham, NC; Department of Urology, Shiraz University of Medical Sciences, Shiraz, Iran., Division of Urology, Duke Cancer Institute, Durham, NC. Electronic address: ., Division of Urology, Duke Cancer Institute, Durham, NC., Division of Urology, Duke Cancer Institute, Durham, NC; SingHealth, Singapore General Hospital, Singapore., Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, OH; Department of Urology, Medical School, Cairo University, Cairo, Egypt., Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, OH.