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Meunier ME, Tantot J, Neuzillet Y, Ghoneim TP, Martin F, Taouil T, Vignac M, Baumert H, Vinh-Hung V, Dussaule-Duchatelle V, Lebret T, Sutter W, Molinié V. Grade groups at diagnosis in African Caribbean men with prostate cancer: Results of a comparative study. Prostate 2019; 79:1640-1646. [PMID: 31376218 DOI: 10.1002/pros.23888] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Accepted: 07/15/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND There are no comparative data on pathological predictors at diagnosis, between African Caribbean and Caucasian men with prostate cancer (PCa), in equal-access centers. The objective of this study was to evaluate the grade groups of an African Caribbean cohort, newly diagnosed with PCa on prostate biopsy, compared with a Caucasian French Metropolitan cohort. METHODS A retrospective, a comparative study was conducted between 2008 and 2016 between the University Hospital of Martinique in the French Caribbean West Indies, and the Saint Joseph Hospital in Paris. Clinical, biological, and pathological data were collected at diagnosis. The primary outcome was the grade groups for Gleason score; the secondary outcome was the PCa detection rate. Multivariate analysis was performed using linear regression. RESULTS Of the 1880 consecutive prostate biopsy performed in the African Caribbean cohort, 945 had a diagnosis of PCa (50.3%) and 500 of 945 in the French cohort (33.8%). African Caribbean patients were older (mean 68.5 vs 67.5 years; P = .028), had worse clinical stage (13.2% vs 5.2% cT3-4; P < .001) and higher median prostate-specific antigen (PSA) level (9.23 vs 8.32 ng/mL; P = .019). On univariate analysis, African Caribbean patients had worse pathological grade groups than French patients (P < .001). Nevertheless, after adjustment on age, stage, and PSA, there were no significant differences between the two cohorts (P = .903). CONCLUSION African Caribbean patients presented higher PCa detection rate, and higher grade groups at diagnosis than French patients in equal-access centers on univariate analysis but not on multivariate analysis. African Caribbean patients with equivalent clinical and biological characteristics than Caucasian patients at diagnosis might expect the same prognosis for PCa.
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Affiliation(s)
- Matthias E Meunier
- Department of Urology, Foch Hospital, Suresnes, France
- Université de Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Juliet Tantot
- Department of Pathology, University Hospital of Lyon-Sud, Pierre Bénite, France
| | - Yann Neuzillet
- Department of Urology, Foch Hospital, Suresnes, France
- Université de Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Tarek P Ghoneim
- Department of Urology, Foch Hospital, Suresnes, France
- Université de Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - François Martin
- Department of Urology, University Hospital of Martinique, Fort-de-France, France
| | - Touafik Taouil
- Department of Urology, University Hospital of Martinique, Fort-de-France, France
| | - Maxime Vignac
- Department of Epidemiology, INSERM UMR-S970, Paris, France
| | - Hervé Baumert
- Department of Urology, Saint Joseph Hospital, Paris, France
| | - Vincent Vinh-Hung
- Department of Radiation Oncology, University Hospital of Martinique, Fort-de-France, France
| | | | - Thierry Lebret
- Department of Urology, Foch Hospital, Suresnes, France
- Université de Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Willy Sutter
- Department of Epidemiology, INSERM UMR-S970, Paris, France
| | - Vincent Molinié
- Department of Pathology, University Hospital of Martinique, Fort-de-France, France
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Liquid Biopsy Potential Biomarkers in Prostate Cancer. Diagnostics (Basel) 2018; 8:diagnostics8040068. [PMID: 30698162 PMCID: PMC6316409 DOI: 10.3390/diagnostics8040068] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 09/12/2018] [Accepted: 09/14/2018] [Indexed: 12/12/2022] Open
Abstract
Prostate cancer (PCa) is the second most common cancer in men worldwide with an incidence of 14.8% and a mortality of 6.6%. Shortcomings in comprehensive medical check-ups in low- and middle-income countries lead to delayed detection of PCa and are causative of high numbers of advanced PCa cases at first diagnosis. The performance of available biomarkers is still insufficient and limited applicability, including logistical and financial burdens, impedes comprehensive implementation into health care systems. There is broad agreement on the need of new biomarkers to improve (i) early detection of PCa, (ii) risk stratification, (iii) prognosis, and (iv) treatment monitoring. This review focuses on liquid biopsy tests distinguishing high-grade significant (Gleason score (GS) ≥ 7) from low-grade indolent PCa. Available biomarkers still lack performance in risk stratification of biopsy naïve patients. However, biomarkers with highly negative predictive values may help to reduce unnecessary biopsies. Risk calculators using integrative scoring systems clearly improve decision-making for invasive prostate biopsy. Emerging biomarkers have the potential to substitute PSA and improve the overall performance of risk calculators. Until then, PSA should be used and may be replaced whenever enough evidence has accumulated for better performance of a new biomarker.
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Nettey OS, Walker AJ, Keeter MK, Singal A, Nugooru A, Martin IK, Ruden M, Gogana P, Dixon MA, Osuma T, Hollowell CMP, Sharifi R, Sekosan M, Yang X, Catalona WJ, Kajdacsy-Balla A, Macias V, Kittles RA, Murphy AB. Self-reported Black race predicts significant prostate cancer independent of clinical setting and clinical and socioeconomic risk factors. Urol Oncol 2018; 36:501.e1-501.e8. [PMID: 30236853 DOI: 10.1016/j.urolonc.2018.06.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 06/11/2018] [Accepted: 06/26/2018] [Indexed: 12/24/2022]
Abstract
INTRODUCTION AND OBJECTIVE Studies have linked Black race to prostate cancer (CaP) risk but most fail to account for established risk factors such as 5-ARI use, prostate volume, socioeconomic status, and hospital setting. We assess whether Black race remains associated with CaP and Gleason ≥3 + 4 CaP, after adjusting for clinical setting and socioeconomic and clinical factors at prostate biopsy, with a focus on men aged 40-54 years, who may be excluded from current screening guidelines. METHODS We recruited 564 men age 40-79 undergoing initial prostate biopsy for abnormal PSA or digital rectal examination (DRE) from three publicly funded and two private hospitals from 2009-2014. Univariate and multivariate analyses examined the associations between hospital type, race, West African Ancestry (WAA), clinical, and sociodemographic risk factors with CaP diagnosis and Gleason ≥3 + 4 CaP. Given changes in CaP screening recommendations, we also assess the multivariate analyses for men aged 40-54. RESULTS Black and White men had similar age, BMI, and prostate volume. Black men had higher PSA (8.10 ng/mL vs. 5.63 ng/mL) and PSA density (0.22 ng/mL/cm3 vs. 0.15 ng/mL/cm3, all p < 0.001). Blacks had higher frequency of CaP (63.1% vs. 41.5%, p<0.001) and Gleason ≥3+4 CaP relative to Whites in both public (27.7% vs 11.6%, p<0.001) and private (48.4% vs 21.6%, p = 0.002) settings. In models adjusted for age, first degree family history, prostate volume, 5-ARI use, hospital type, income, marital and educational status, Black race was independently associated with overall CaP diagnosis (OR = 2.13, p = 0.002). There was a significant multiplicative interaction with Black race and abnormal DRE for Gleason ≥3 + 4 CaP (OR = 2.93, p = 0.01). WAA was not predictive of overall or significant CaP among Black men. Black race (OR = 5.66, p = 0.02) and family history (OR = 4.98, p = 0.01) were independently positively associated with overall CaP diagnosis for men aged 40 to 54. CONCLUSIONS Black race is independently associated with CaP and Gleason ≥3+4 CaP after accounting for clinical and socioeconomic risk factors including clinical setting and WAA, and has a higher odds ratio of CaP diagnosis in younger men. Further investigation into optimizing screening in Black men aged 40 to 54 is warranted.
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Affiliation(s)
- Oluwarotimi S Nettey
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Austin J Walker
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Mary Kate Keeter
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Ashima Singal
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Aishwarya Nugooru
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Iman K Martin
- Division of Cancer Prevention, National Cancer Institute, Bethesda, MD
| | - Maria Ruden
- Department of Medicine, University of Illinois at Chicago, Chicago, IL
| | - Pooja Gogana
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Michael A Dixon
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | | | | | - Roohollah Sharifi
- Section of Urology, Jesse Brown VA Medical Center, Chicago, IL; Department of Urology, University of Illinois at Chicago School of Medicine, Chicago, IL
| | - Marin Sekosan
- Department of Pathology, Cook County Health and Hospitals System, Chicago, IL
| | - Ximing Yang
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - William J Catalona
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Andre Kajdacsy-Balla
- Department of Pathology, University of Illinois at Chicago School of Medicine, Chicago, IL
| | - Virgilia Macias
- Department of Pathology, University of Illinois at Chicago School of Medicine, Chicago, IL
| | - Rick A Kittles
- Division of Health Equities, Department of Population Sciences, City of Hope Cancer Center, Duarte, CA
| | - Adam B Murphy
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL; Section of Urology, Jesse Brown VA Medical Center, Chicago, IL.
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