Race does not predict the development of metastases in men with nonmetastatic castration-resistant prostate cancer

Colette A. Whitney, Lauren E. Howard, Christopher L. Amling, William J. Aronson, Matthew R. Cooperberg, Christopher J. Kane, Martha K. Terris, Stephen J. Freedland

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

BACKGROUND: Although race is associated with prostate cancer progression in early stage disease, once men have advanced disease, it is unclear whether race continues to predict a poor outcome. The authors hypothesized that, in an equal-access setting among patients with castration-resistant prostate cancer (CRPC) and no known metastases (M0/Mx), black men would receive imaging tests at similar rates as nonblack men (ie, there would be an equal opportunity to detect metastases) but would have a higher risk of metastatic disease. METHODS: In total, 837 men who were diagnosed with M0/Mx CRPC during 2000 through 2014 from 5 Veterans Affairs hospitals in the SEARCH (Shared Equal Access Regional Cancer Hospital) database were analyzed. Data on all imaging tests after CRPC diagnosis were collected, including date, type, and outcome. Multivariable Cox models were used to test associations between race and the time to first metastasis, first bone metastasis, first bone scan, second bone scan among men who had a negative first bone scan, and overall survival. RESULTS: Black men (n = 306) were equally as likely as nonblack men (n = 531) to receive a first and second bone scan after a diagnosis of CRPC. There were no significant differences in the risk of developing any metastases, bone metastases, time to bone scans, or overall survival between black men and nonblack men (all P >.2). CONCLUSIONS: The lack of racial differences in the development of metastases and scanning practices observed in this study suggests that, once men have a diagnosis of M0/Mx CRPC, race may not be a prognostic factor. Efforts to understand prostate cancer racial disparities may derive greater benefit by focusing on the risk of developing prostate cancer and on the outcomes of men who have early stage disease. Cancer 2016;122:3848–3855.

Original languageEnglish (US)
Pages (from-to)3848-3855
Number of pages8
JournalCancer
Volume122
Issue number24
DOIs
StatePublished - Dec 15 2016

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Castration
Prostatic Neoplasms
Neoplasm Metastasis
Bone and Bones
Veterans Hospitals
Cancer Care Facilities
Survival
Proportional Hazards Models
Databases

Keywords

  • metastasis
  • nonmetastatic castration-resistant
  • prostatic neoplasms
  • race
  • scanning practice patterns

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Whitney, C. A., Howard, L. E., Amling, C. L., Aronson, W. J., Cooperberg, M. R., Kane, C. J., ... Freedland, S. J. (2016). Race does not predict the development of metastases in men with nonmetastatic castration-resistant prostate cancer. Cancer, 122(24), 3848-3855. https://doi.org/10.1002/cncr.30221

Race does not predict the development of metastases in men with nonmetastatic castration-resistant prostate cancer. / Whitney, Colette A.; Howard, Lauren E.; Amling, Christopher L.; Aronson, William J.; Cooperberg, Matthew R.; Kane, Christopher J.; Terris, Martha K.; Freedland, Stephen J.

In: Cancer, Vol. 122, No. 24, 15.12.2016, p. 3848-3855.

Research output: Contribution to journalArticle

Whitney, CA, Howard, LE, Amling, CL, Aronson, WJ, Cooperberg, MR, Kane, CJ, Terris, MK & Freedland, SJ 2016, 'Race does not predict the development of metastases in men with nonmetastatic castration-resistant prostate cancer', Cancer, vol. 122, no. 24, pp. 3848-3855. https://doi.org/10.1002/cncr.30221
Whitney CA, Howard LE, Amling CL, Aronson WJ, Cooperberg MR, Kane CJ et al. Race does not predict the development of metastases in men with nonmetastatic castration-resistant prostate cancer. Cancer. 2016 Dec 15;122(24):3848-3855. https://doi.org/10.1002/cncr.30221
Whitney, Colette A. ; Howard, Lauren E. ; Amling, Christopher L. ; Aronson, William J. ; Cooperberg, Matthew R. ; Kane, Christopher J. ; Terris, Martha K. ; Freedland, Stephen J. / Race does not predict the development of metastases in men with nonmetastatic castration-resistant prostate cancer. In: Cancer. 2016 ; Vol. 122, No. 24. pp. 3848-3855.
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abstract = "BACKGROUND: Although race is associated with prostate cancer progression in early stage disease, once men have advanced disease, it is unclear whether race continues to predict a poor outcome. The authors hypothesized that, in an equal-access setting among patients with castration-resistant prostate cancer (CRPC) and no known metastases (M0/Mx), black men would receive imaging tests at similar rates as nonblack men (ie, there would be an equal opportunity to detect metastases) but would have a higher risk of metastatic disease. METHODS: In total, 837 men who were diagnosed with M0/Mx CRPC during 2000 through 2014 from 5 Veterans Affairs hospitals in the SEARCH (Shared Equal Access Regional Cancer Hospital) database were analyzed. Data on all imaging tests after CRPC diagnosis were collected, including date, type, and outcome. Multivariable Cox models were used to test associations between race and the time to first metastasis, first bone metastasis, first bone scan, second bone scan among men who had a negative first bone scan, and overall survival. RESULTS: Black men (n = 306) were equally as likely as nonblack men (n = 531) to receive a first and second bone scan after a diagnosis of CRPC. There were no significant differences in the risk of developing any metastases, bone metastases, time to bone scans, or overall survival between black men and nonblack men (all P >.2). CONCLUSIONS: The lack of racial differences in the development of metastases and scanning practices observed in this study suggests that, once men have a diagnosis of M0/Mx CRPC, race may not be a prognostic factor. Efforts to understand prostate cancer racial disparities may derive greater benefit by focusing on the risk of developing prostate cancer and on the outcomes of men who have early stage disease. Cancer 2016;122:3848–3855.",
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AU - Whitney, Colette A.

AU - Howard, Lauren E.

AU - Amling, Christopher L.

AU - Aronson, William J.

AU - Cooperberg, Matthew R.

AU - Kane, Christopher J.

AU - Terris, Martha K.

AU - Freedland, Stephen J.

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N2 - BACKGROUND: Although race is associated with prostate cancer progression in early stage disease, once men have advanced disease, it is unclear whether race continues to predict a poor outcome. The authors hypothesized that, in an equal-access setting among patients with castration-resistant prostate cancer (CRPC) and no known metastases (M0/Mx), black men would receive imaging tests at similar rates as nonblack men (ie, there would be an equal opportunity to detect metastases) but would have a higher risk of metastatic disease. METHODS: In total, 837 men who were diagnosed with M0/Mx CRPC during 2000 through 2014 from 5 Veterans Affairs hospitals in the SEARCH (Shared Equal Access Regional Cancer Hospital) database were analyzed. Data on all imaging tests after CRPC diagnosis were collected, including date, type, and outcome. Multivariable Cox models were used to test associations between race and the time to first metastasis, first bone metastasis, first bone scan, second bone scan among men who had a negative first bone scan, and overall survival. RESULTS: Black men (n = 306) were equally as likely as nonblack men (n = 531) to receive a first and second bone scan after a diagnosis of CRPC. There were no significant differences in the risk of developing any metastases, bone metastases, time to bone scans, or overall survival between black men and nonblack men (all P >.2). CONCLUSIONS: The lack of racial differences in the development of metastases and scanning practices observed in this study suggests that, once men have a diagnosis of M0/Mx CRPC, race may not be a prognostic factor. Efforts to understand prostate cancer racial disparities may derive greater benefit by focusing on the risk of developing prostate cancer and on the outcomes of men who have early stage disease. Cancer 2016;122:3848–3855.

AB - BACKGROUND: Although race is associated with prostate cancer progression in early stage disease, once men have advanced disease, it is unclear whether race continues to predict a poor outcome. The authors hypothesized that, in an equal-access setting among patients with castration-resistant prostate cancer (CRPC) and no known metastases (M0/Mx), black men would receive imaging tests at similar rates as nonblack men (ie, there would be an equal opportunity to detect metastases) but would have a higher risk of metastatic disease. METHODS: In total, 837 men who were diagnosed with M0/Mx CRPC during 2000 through 2014 from 5 Veterans Affairs hospitals in the SEARCH (Shared Equal Access Regional Cancer Hospital) database were analyzed. Data on all imaging tests after CRPC diagnosis were collected, including date, type, and outcome. Multivariable Cox models were used to test associations between race and the time to first metastasis, first bone metastasis, first bone scan, second bone scan among men who had a negative first bone scan, and overall survival. RESULTS: Black men (n = 306) were equally as likely as nonblack men (n = 531) to receive a first and second bone scan after a diagnosis of CRPC. There were no significant differences in the risk of developing any metastases, bone metastases, time to bone scans, or overall survival between black men and nonblack men (all P >.2). CONCLUSIONS: The lack of racial differences in the development of metastases and scanning practices observed in this study suggests that, once men have a diagnosis of M0/Mx CRPC, race may not be a prognostic factor. Efforts to understand prostate cancer racial disparities may derive greater benefit by focusing on the risk of developing prostate cancer and on the outcomes of men who have early stage disease. Cancer 2016;122:3848–3855.

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