Decisional regret after robotic-assisted laparoscopic prostatectomy is higher in African American men
Decisional regret after robotic-assisted laparoscopic prostatectomy is higher in African American men
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DOI：
10.1016/j.urolonc.2013.10.011
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发表时间：
2014-05-01
影响因子：
2.7
通讯作者：
Samadi, David B.
中科院分区：
文献类型：
--
作者：
Collingwood, Shemille A.;McBride, Russell B.;Samadi, David B.
目的：纵向研究报告了非裔美国人（AA）男性前列腺癌（PCa）的种族差异，包括更高的发病率、更具侵袭性的肿瘤生物学和更高的癌症特异性死亡率。在PCa患者中，对初级治疗选择的后悔被低估了。我们调查了机器人辅助腹腔镜前列腺切除术后不同种族和社会经济线的临床病理变量之间的关系。材料和方法：我们对484名白人和72名AA型前列腺癌患者进行了治疗决策后悔评估，这些患者在机器人辅助腹腔镜前列腺切除术后进行了中位16.6个月的随访。社会经济地位（SES）信息汇总自2010年美国人口普查邮政编码数据。比较两组围手术期临床病理特征及功能结局。采用单变量和多变量回归分析来评估种族、总经济地位和其他临床和人口学特征对决策后悔的影响。结果：绝大多数（87.7%）的人不后悔接受治疗的决定。然而，黑人患者后悔的比例高于白人患者（分别为20.6%和11.2%,P = 0.03）。AA男性和白人男性在所有功能、临床和病理特征上都相似，但AA男性的年龄较小（分别为56岁和60岁，P < 0.001）。虽然不同种族的社会地位有显著差异（P < 0.001），但后悔没有因社会地位而差异（beta = -1.53; P = 0.15）。然而，种族、术后性功能障碍、尿垫使用和住院时间与决定后悔显著相关。结论：在调整临床病理特征和术后功能结果后，AA男性比白人男性更后悔。(C) 2014爱思唯尔公司版权所有。
Objectives: Longitudinal studies report racial disparities in prostate cancer (PCa) including greater incidence, more aggressive tumor biology, and increased cancer-specific mortality in African American (AA) men. Regret concerning primary treatment selection is underevaluated in patients with PCa. We investigated the relationships between clinicopathologic variables across racial and socioeconomic lines following robotic-assisted laparoscopic prostatectomy.Materials and methods: We assessed treatment decisional regret using a validated questionnaire in a total of 484 white and 72 AA patients with PCa who were followed up for a median of 16.6 months post robotic-assisted laparoscopic prostatectomy. Socioeconomic status (SES) information was aggregated from 2010 US census zip code data. Perioperative clinicopathologic characteristics and functional outcomes were compared between groups. Univariate and multivariate regression analyses were used to evaluate the influence of race, aggregate SES, and other clinical and demographic characteristics on decisional regret.Results: The majority (87.7%) of the population was not regretful of their decision to undergo treatment. However, a greater proportion of AA vs. white patients were regretful (20.6% vs. 11.2%, respectively; P = 0.03). AA and white men were similar on all functional, clinical, and pathologic features with the exception of younger age among AA men (56 vs. 60 y, respectively; P < 0.001). Although there were significant differences in SES by race (P < 0.001), regret did not differ by SES (beta = -1.53; P = 0.15). Race, postoperative sexual dysfunction, pad usage, and length of hospital stay, however, were significantly associated with decisional regret.Conclusions: AA men were more regretful than white men, after adjusting for clinicopathologic characteristics and postoperative functional outcomes. (C) 2014 Elsevier Inc. All rights reserved.