Abstract

You have accessJournal of UrologyCME1 May 2022MP43-16 RACIAL DISPARITIES IN RATES OF GLEASON GRADE RECLASSIFICATION IN A MULTI-INSTITUTIONAL PROSTATE CANCER ACTIVE SURVEILLANCE COHORT: A PENNSYLVANIA UROLOGY REGIONAL COLLABORATIVE (PURC) ANALYSIS Rohit Reddy, David Strauss, Matthew Loecher, Kaynaat Syed, John Danella, Serge Ginzburg, Laurence Belkoff, Jeffrey Tomaszewski, Edouard Trabulsi, Eric A. Singer, Bruce L. Jacobs, Jay Raman, Thomas Guzzo, Thomas Guzzo, Robert Uzzo, and Adam C. Reese Rohit ReddyRohit Reddy More articles by this author , David StraussDavid Strauss More articles by this author , Matthew LoecherMatthew Loecher More articles by this author , Kaynaat SyedKaynaat Syed More articles by this author , John DanellaJohn Danella More articles by this author , Serge GinzburgSerge Ginzburg More articles by this author , Laurence BelkoffLaurence Belkoff More articles by this author , Jeffrey TomaszewskiJeffrey Tomaszewski More articles by this author , Edouard TrabulsiEdouard Trabulsi More articles by this author , Eric A. SingerEric A. Singer More articles by this author , Bruce L. JacobsBruce L. Jacobs More articles by this author , Jay RamanJay Raman More articles by this author , Thomas GuzzoThomas Guzzo More articles by this author , Thomas GuzzoThomas Guzzo More articles by this author , Robert UzzoRobert Uzzo More articles by this author , and Adam C. ReeseAdam C. Reese More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002609.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Active surveillance (AS) is an established management option for patients with low-risk prostate cancer (CaP), with favorable long-term oncologic outcomes. Previous literature has shown significant racial CaP disparities with African-American (AA) men having a higher incidence of disease and more aggressive tumors. The purpose of this study is to analyze a prospectively maintained multi-institutional AS database to compare Gleason grade reclassification rates on confirmatory biopsy stratified by race. METHODS: The Pennsylvania Urological Regional Collaborative (PURC) is a prospectively maintained CaP quality improvement collaborative. The PURC database was queried for low risk CaP men on AS divided by race (AA vs Caucasian/Other). The primary outcome of interest was the rate of Gleason grade reclassification at the time of confirmatory biopsy. RESULTS: The study cohort included 536 patients with low risk CaP on AS, comprised of 119 (22.2%) AA and 417 (77.8%) Caucasian/Other men. Other than BMI, there were no significant differences in either patient demographics or index biopsy parameters between groups (Table 1). AA men had a significantly higher rate of grade reclassification (35.3% vs 25.4%, p=0.034). On multivariate analysis, AA race was an independent predictor of grade reclassification (OR 1.82, p=0.042) (Table 2). CONCLUSIONS: Established AS selection criteria and surveillance protocols fail to account for potential racial disparities in oncologic outcomes among patients with CaP. AA men in PURC exhibited a higher rate of grade reclassification on confirmatory biopsy, suggesting that AA men may need alternate AS surveillance criteria potentially including adjunct studies (mpMRI, genomic studies) to accurately risk stratify their CaP. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e747 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rohit Reddy More articles by this author David Strauss More articles by this author Matthew Loecher More articles by this author Kaynaat Syed More articles by this author John Danella More articles by this author Serge Ginzburg More articles by this author Laurence Belkoff More articles by this author Jeffrey Tomaszewski More articles by this author Edouard Trabulsi More articles by this author Eric A. Singer More articles by this author Bruce L. Jacobs More articles by this author Jay Raman More articles by this author Thomas Guzzo More articles by this author Thomas Guzzo More articles by this author Robert Uzzo More articles by this author Adam C. Reese More articles by this author Expand All Advertisement PDF DownloadLoading ...