Impact of androgen deprivation therapy on racial/ethnic disparities in the survival of older men treated for locoregional prostate cancer.
Impact of androgen deprivation therapy on racial/ethnic disparities in the survival of older men treated for locoregional prostate cancer.
复制标题
DOI：
10.1177/107327480901600210
复制
发表时间：
2009-04
期刊：
影响因子：
--
通讯作者：
Du XL
中科院分区：
文献类型：
--
作者：
Holmes L Jr;Chan W;Jiang Z;Ward D;Essien EJ;Du XL
种族差异在前列腺癌（CaP）治疗和生存中持续存在，但雄激素剥夺治疗（ADT）的差异以及它在多大程度上影响生存的种族差异仍有待充分评估。使用监测流行病学和最终结果-医疗保险相关数据，我们检查了1992年至1999年期间诊断为局部CaP并随访至2003年的大型男性队列（n= 64，475）。采用考克斯比例风险模型分析ADT和种族对生存率的影响。非洲裔美国人（AA）接受ADT的比例（24%）显著低于白人（27%）、亚洲人（34%）和西班牙裔美国人（28.7%），p < 0.05。与白人相比，AA人种与死亡率统计学显著性增加相关，风险比（HR）= 1.26; 95% CI = 1.21 - 1.32，在调整ADT后仍具有显著性，但在控制主要治疗后显著降低（根治性直肠癌切除术、放疗、观察等待）（HR = 1.06; 1.01 − 1.10），在控制合并症后不再具有统计学显著性（HR = 0.98; 0.94 −1.03）。在接受ADT、主要治疗（即手术和手术联合放疗）和合并症方面存在明显的种族差异。然而，生存期的种族差异不受ADT种族差异的影响，但可以通过主要治疗的种族差异和合并症的种族差异来解释。
Racial disparities persist in prostate cancer (CaP) treatment and survival, but disparities in androgen deprivation therapy (ADT), and to what degree it affects racial differences in survival remains to be fully assessed. Using the Surveillance Epidemiology and End Results-Medicare linked data, we examined a large cohort of men (n=64,475) diagnosed with locoregional CaP during 1992 to 1999 and followed through 2003. The effects of ADT and race on survival were analyzed using Cox proportional hazards model. The receipt of ADT was significantly lower in African Americans (AA), (24%) relative to Caucasians (27%), Asians (34%), and Hispanics (28.7%), p < 0.05. Compared with Caucasians, AA race was associated with a statistically significant increased mortality, Hazard Ratio (HR) = 1.26; 95% CI = 1.21−1.32, which remained significant after adjusting for ADT, but was substantially decreased after controlling for primary therapies (radical prostatectomy, radiation, watchful waiting) (HR = 1.06; 1.01 − 1.10), and was no longer statistically significant after controlling for comorbidities (HR = 0.98; 0.94 −1.03). There were marked racial variations in the receipt of ADT, primary therapies namely surgery and surgery combined with radiation, and comorbidities. However, racial disparities in survival were not affected by racial variations in ADT, but were explained by racial variations in primary therapies, and by racial differences in comorbidities.
登录
查看更多内容
影响因子：
--
作者：
Corbie-Smith, G;Thomas, SB;St George, DMM
通讯作者：
St George, DMM
影响因子：
6.6
作者：
Fowler, JE;Terrell, F
通讯作者：
Terrell, F
影响因子：
3
作者：
Desch, CE;Penberthy, L;Retchin, SM
通讯作者：
Retchin, SM
影响因子：
158.5
作者：
Bach, PB;Cramer, LD;Begg, CB
通讯作者：
Begg, CB
影响因子：
6.2
作者：
Du, XLL;Chan, WY;Fang, SY
通讯作者：
Fang, SY