Racial differences in clinical progression among Medicare recipients after treatment for localized prostate cancer (United States)
Racial differences in clinical progression among Medicare recipients after treatment for localized prostate cancer (United States)
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DOI：
10.1007/s10552-006-0017-7
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发表时间：
2006-08-01
影响因子：
2.3
通讯作者：
Godley, PA
中科院分区：
文献类型：
--
作者：
Cohen, JH;Schoenbach, VJ;Godley, PA
目的前列腺癌复发影响患者的生活质量和确定性治疗后前列腺癌特异性死亡的风险。我们调查了白色、黑人、西班牙裔和亚洲患者在一个大型的、基于人群的database.Methods合并的监测、流行病学和最终结果程序（SEER）和医疗保险文件中的无病生存率差异，提供了23，353名白色患者、2，814名黑人患者、480名西班牙裔患者、1986年至1996年间，在5个SEER站点中，566例年龄在65-84岁之间诊断为临床局限性前列腺癌的亚洲患者。患者随访至1998年。采用Kaplan-Meier生存曲线和考克斯回归模型分析无病生存期的种族差异。结果黑人患者的第75百分位数无病生存期比白色患者短13个月（95%置信区间[CI]：6.2-19.8个月），比西班牙裔患者少29.7个月（95% CI：4.4-55.0个月），比亚洲患者少39.1个月（95% CI：12.1-66.1个月）。在多变量分析中，黑人预测较短的无病生存手术患者，但不是在放射patients.Conclusions黑人患者经历了较短的无病生存期相比，白色，西班牙裔和亚洲患者，和无病生存的白色，西班牙裔和亚洲患者无统计学差异。前列腺癌早期复发可能有助于解释黑人患者前列腺癌死亡风险增加的原因。
Objective Prostate cancer recurrence impacts patient quality of life and risk of prostate-cancer specific death following definitive treatment. We investigate differences in disease-free survival among white, black, Hispanic, and Asian patients in a large, population-based database.Methods Merged Surveillance, Epidemiology, and End Results Program (SEER) and Medicare files provided data on 23,353 white patients, 2,814 black patients, 480 Hispanic patients, and 566 Asian patients diagnosed at age 65-84 years with clinically localized prostate cancer between 1986 and 1996 in five SEER sites. Patients were followed through 1998. Racial differences in disease-free survival were assessed using Kaplan-Meier survival curves and Cox regression models.Results The 75th percentile disease-free survival time for black patients was 13 months less than that for white patients (95% confidence interval [CI]: 6.2-19.8 months), 29.7 months less than that for Hispanic patients (95% CI: 4.4-55.0 months), and 39.1 months less than that for Asian patients (95% CI: 12.1-66.1 months). In multivariate analysis, black race predicted shorter disease-free survival among surgery patients, but not among radiation patients.Conclusions Black patients experienced shorter disease-free survival compared to white, Hispanic, and Asian patients, and the disease-free survival of white, Hispanic, and Asian patients were not statistically different. Earlier recurrence of prostate cancer may help explain black patients' increased risk of mortality from prostate cancer.