Racial/ethnic differences in functional outcomes in the 5 years after diagnosis of localized prostate cancer
Racial/ethnic differences in functional outcomes in the 5 years after diagnosis of localized prostate cancer
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DOI：
10.1200/jco.2004.09.127
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发表时间：
2004-10-15
影响因子：
45.3
通讯作者：
Hamilton, AS
中科院分区：
文献类型：
--
作者：
Johnson, TK;Gilliland, FD;Hamilton, AS
目的：我们调查的种族/民族的差异，在功能的结果，诊断后5年的男性积极治疗局限性prostate cancer.Patients和方法患者的前列腺癌预后研究，以人群为基础的队列研究，调查患者在6，12，24和60个月后诊断。按主要治疗对分析进行分层。使用广义估计方程评估每个时间点的人种/种族差异，调整治疗前功能、诊断时年龄、二次治疗和其他混杂因素。每个功能域的调整后的汇总得分计算为每个timeperiod.Results患者包括1,475非西班牙裔白色，321非洲裔美国人，和279西班牙裔前列腺癌患者。60个月后，在前列腺切除术患者中，非裔美国人的性功能评分显著高于非西班牙裔白人（43.9 v36.1; P = 0.02），但更可能有中度至重度的性功能问题（50.6% v44.4%; P = 0.04）。非裔美国人在5年时的尿功能评分也高于非西班牙裔白人（78.5 v72.4; P = 0.04），并且不太可能有失禁问题。放疗后的性功能和肠功能的变化没有显着的种族/ethnic difficulties.Conclusion这个长期的队列研究发现，在直肠癌切除术患者中，非洲裔美国人有更好的恢复性功能和泌尿功能在60个月后诊断，可能是轻微的临床意义，尽管报告更多的问题与性功能比非西班牙裔白人。需要更多的研究来了解这些差异的原因。相比之下，没有发现从放射治疗中恢复的种族/民族差异。（C）2004年由美国临床肿瘤学会。
Purpose We investigated racial/ethnic differences in functional outcomes up to 5 years after diagnosis among men with aggressively treated localized prostate cancer.Patients and Methods Patients were from the Prostate Cancer Outcomes Study, a population-based cohort study that surveyed patients at 6, 12, 24, and 60 months after diagnosis. Analyses were stratified by primary treatment. Racial/ethnic differences at each time point were assessed using Generalized Estimating Equations, adjusting for pretreatment function, age at diagnosis, secondary treatment, and other confounders. An adjusted summary score for each functional domain was calculated for each time period.Results Patients included 1,475 non-Hispanic white, 321 African-American, and 279 Hispanic prostate cancer patients. After 60 months, among prostatectomy patients, African-Americans had significantly higher sexual function scores than non-Hispanic whites (43.9 v36.1; P = .02), but were more likely to have a moderate to big problem with sexual function (50.6% v 44.4%; P = .04). African-Americans also had higher urinary function scores at 5 years than non-Hispanic whites (78.5 v 72.4; P = .04) and were less likely to have problems with incontinence. Changes in sexual and bowel function after radiotherapy showed no significant racial/ethnic differences.Conclusion This long-term cohort study found that,among prostatectomy patients, African-Americans had better recovery of sexual and urinary function at 60 months after diagnosis that was likely to be of mild clinical significance, despite reporting more problems with sexual function than non-Hispanic whites. More study is necessary to understand reasons for these differences. In contrast, no racial/ethnic differences in recovery from radiotherapy were found. (C) 2004 by American Society of Clinical Oncology.