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Khandwala YS, Ohanian A, Huang FW. Prostate Cancer in the Caribbean: A Baseline Assessment of Current Practices and Potential Needs. Cancer Control 2022. [PMCID: PMC8961354 DOI: 10.1177/10732748221082372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Afro-Caribbean men have a higher risk of prostate cancer than any other population of men
in the world. However, the Caribbean is composed of a heterogenous group of healthcare
systems located on small islands which makes population-based studies difficult to conduct
and interpret. The aim of this review is to compile previously published data on the state
of prostate cancer in Caribbean men and to highlight potential healthcare needs that can
be addressed by public health efforts. We reviewed three databases and identified relevant
papers that were subsequently searched by the authors. Peer-reviewed studies published in
the English language after 2010 with a focus on prostate cancer diagnosis, management, and
outcomes of Caribbean men were prioritized. Afro-Caribbean men were found to have a higher
incidence and mortality rate compared to their counterparts. Misperception about the
disease, lack of regional guidelines, and poor access to care are compounding factors that
result in worse outcomes for these men compared to high-income nations. Urologists and
oncologists in the region, while well-trained, are limited in number and in most cases do
not offer newer treatment modalities. Overall, only a few island nations have cancer
registries, and there remains a significant need for more population-based studies to
assess guideline adherence and outcomes. Until further research and investment in the
region is made, the disparity between the care received by Afro-Caribbean men and their
counterparts will likely remain.
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Affiliation(s)
- Yash S Khandwala
- Department of Urology, Stanford University Medical Center, Stanford, CA, USA
| | - Alec Ohanian
- Division of Hematology and Oncology, University of California, San Francisco, CA, USA
| | - Franklin W Huang
- Division of Hematology and Oncology, University of California, San Francisco, CA, USA
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Katayama N, Nakamura K, Yorozu A, Kikuchi T, Fukushima M, Saito S, Dokiya T. Biochemical outcomes and predictive factors by risk group after permanent iodine-125 seed implantation: Prospective cohort study in 2,316 patients. Brachytherapy 2019; 18:574-582. [PMID: 31153759 DOI: 10.1016/j.brachy.2019.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 02/28/2019] [Accepted: 03/25/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate the biochemical freedom from failure (bFFF) by risk group and treatment modality and the predictive factors of bFFF by risk group in patients with prostate cancer undergoing permanent seed implantation (PI) with or without external beam radiation therapy (EBRT) in a nationwide prospective cohort study (Japanese Prostate Cancer Outcome Study of Permanent Iodine-125 [I-125] Seed Implantation) in Japan during the first 2 years. METHODS AND MATERIALS The analyses included 2,316 participants in 42 institutions; bFFF was evaluated using the Phoenix definition and calculated using the Kaplan-Meier method, and the Cox proportional hazards model was used to identify the factors associated with bFFF. RESULTS Median followup period was 60.0 months. The 5-year bFFF rates in all patients, 1,028 low-risk patients, 1,114 intermediate-risk patients, and 133 high-risk patients were 93.6%, 94.9%, 92.7%, and 91.1%, respectively. The 5-year bFFF rates in the PI group and EBRT combination therapy group were 93.7% and 93.3%, respectively. In a multivariate analysis, younger age, higher Gleason score (GS), higher percent positive biopsies (%PB), and lower prostate V100 (p = 0.0012, 0.0030, 0.0026, and 0.0368) in all patients; younger age, higher pretreatment prostate-specific antigen, and lower prostate V100 (p = 0.0002, 0.0048, and 0.0012) in low-risk patients; higher GS, higher %PB, and no hormonal treatment (p = 0.0005, 0.0120, and 0.0022) in intermediate-risk patients; and higher GS and higher %PB (p = 0.0329 and 0.0120) in high-risk patients were significantly associated with bFFF. CONCLUSIONS PI with or without EBRT resulted in excellent short-term biochemical outcomes in all risk groups, especially in high-risk patients. Age, pretreatment prostate-specific antigen, and prostate V100 in low-risk patients; GS, %PB, and hormonal treatment in intermediate-risk patients; and GS and %PB in high-risk patients were independently affected bFFF.
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Affiliation(s)
- Norihisa Katayama
- Department of Radiology, Okayama University Medical School, Okayama, Japan.
| | - Katsumasa Nakamura
- Department of Radiation Oncology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Atsunori Yorozu
- Department of Radiation Oncology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | | | | | - Shiro Saito
- Department of Urology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
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Leduc N, Escarmant P, Vinh-Hung V, Joachim C, Véronique-Baudin J. In Regard to Gajjar et al. Int J Radiat Oncol Biol Phys 2018; 102:1600-1601. [DOI: 10.1016/j.ijrobp.2018.08.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 07/27/2018] [Accepted: 08/24/2018] [Indexed: 11/26/2022]
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Joachim C, Veronique-Baudin J, Ulric-Gervaise S, Macni J, Almont T, Pierre-Louis O, Godaert L, Drame M, Novella JL, Farid K, Vinh-Hung V, Escarmant P. Pattern of care of prostate cancer patients across the Martinique: results of a population-based study in the Caribbean. BMC Cancer 2018; 18:1130. [PMID: 30445934 PMCID: PMC6240273 DOI: 10.1186/s12885-018-5047-5] [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: 06/19/2018] [Accepted: 11/06/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The French West-Indies rank first for both prostate cancer incidence and mortality rates. Analyzing diagnostic and therapeutic procedures among patients with prostate cancer, using data from a population-based cancer registry, is essential for cancer surveillance and research strategies. METHODS This retrospective observational cohort study was based on data from the Martinique Cancer Registry. Records of 452 patients diagnosed with prostate cancer in 2013 were retrieved from the registry. Data extracted were: socio-demographic and clinical characteristics, circumstances of diagnosis, PSA level at diagnosis, Gleason score and risk of disease progression. Stage at diagnosis and patterns of care among prostate cancer patients were analyzed. RESULTS Mean age at diagnosis was 67 ± 8 years; 103 (28.5%) were symptomatic at diagnosis. Digital rectal exam was performed in 406 (93.8%). Clinical stage was available in 385 (85.2%); tumours were localized in 322/385 (83.6%). Overall, 17.9% were at low risk, 36.4% at intermediate and 31.9% at high risk; 13.8% were regional/metastatic cancers. Median PSA level at diagnosis was 8.16 ng/mL (range 1.4-5000 ng/mL). A total of 373 patients (82.5%) received at least one treatment, while 79 (17.5%) had active surveillance or watchful waiting. Among patients treated with more than one therapeutic strategy, the most frequent combination was external radiotherapy with androgen deprivation (n = 102, 22.6%). CONCLUSIONS This study provides detailed data regarding the quality of diagnosis and management of patients with prostate cancer in Martinique. Providing data on prostate cancer is essential for the development of high-priority public health measures for the Caribbean.
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Affiliation(s)
- Clarisse Joachim
- CHU Martinique, UF1441 Registre des cancers de la Martinique, Pôle de Cancérologie Hématologie Urologie Pathologie, CS 90632, 97200, Fort-de-France, Martinique, France.
| | - Jacqueline Veronique-Baudin
- CHU Martinique, UF1441 Registre des cancers de la Martinique, Pôle de Cancérologie Hématologie Urologie Pathologie, CS 90632, 97200, Fort-de-France, Martinique, France
| | - Stephen Ulric-Gervaise
- CHU Martinique, UF1441 Registre des cancers de la Martinique, Pôle de Cancérologie Hématologie Urologie Pathologie, CS 90632, 97200, Fort-de-France, Martinique, France
| | - Jonathan Macni
- CHU Martinique, UF1441 Registre des cancers de la Martinique, Pôle de Cancérologie Hématologie Urologie Pathologie, CS 90632, 97200, Fort-de-France, Martinique, France
| | - Thierry Almont
- CHU Toulouse Paule de Viguier, Groupe de recherche en fertilité humaine EA 3694, Toulouse, France.,Groupe d'Étude, de Formation et de Recherche en Andrologie, Urologie et Sexologie Médecine de la Reproduction, Toulouse, France
| | - Olivier Pierre-Louis
- CHU Martinique, Pôle de Cancérologie, Hématologie Urologie Pathologie, 97200 Fort-de-France, Martinique, France
| | - Lidvine Godaert
- CHU de Martinique, Pôle de Gériatrie, 97200 Fort-de-France, Martinique, France
| | - Moustapha Drame
- CHU de Reims, Pôle Recherche et Santé publique, 51100 Reims, France
| | | | - Karim Farid
- CHU Martinique, Pole d'imagerie Médicale Service de Médecine nucléaire, 97200 Fort-de-France, Martinique, France
| | - Vincent Vinh-Hung
- CHU MARTINIQUE, Pôle de Cancérologie Hématologie Urologie Pathologie, 97200 Fort-de-France, Martinique, France
| | - Patrick Escarmant
- CHU MARTINIQUE, Pôle de Cancérologie Hématologie Urologie Pathologie, 97200 Fort-de-France, Martinique, France
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Joachim C, Veronique-Baudin J, Almont T, Ulric-Gervaise S, Macni J, Pierre-Louis O, Godaert L, Drame M, Novella JL, Farid K, Vinh-Hung V, Escarmant P. Cohort profile: the Martinique Cancer Registry and the quality of life prostate cancer cohort (QoL Prostate-MQ): challenges and prospects for reducing disparities in the Caribbean. BMJ Open 2018; 8:e021540. [PMID: 30049695 PMCID: PMC6067331 DOI: 10.1136/bmjopen-2018-021540] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
PURPOSE Recording cancer data in cancer registries is essential for producing reliable population-based data for service planning, monitoring and evaluation. Prostate cancer (PCa) remains the most frequent type of cancer in terms of incidence and mortality in men in the Caribbean. The quality of life PCa cohort will assess quality of life and patient outcomes in Martinique using a digital platform for patient-reported outcome measures. PARTICIPANTS The Martinique Cancer Registry database is the largest clinical database among the French population-based cancer registries in the Caribbean, including more than 38 000 cancer cases, with 1650 new cancer cases per year, including 550 new PCa cases per year (2010-2014 latest period). In 2018, follow-up will include vital status, assessment of quality of life with the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ) Core 30 and the Prostate cancer module QLQ-PR25. Urinary incontinence and erectile dysfunction recorded prior to treatment will be analysed 1 and 5 years after treatment. FINDINGS TO DATE The registry includes data on circumstances of diagnosis, clinical stage at diagnosis. For PCa, the registry includes blood prostate-specific antigen level at the time of diagnosis, Gleason score and primary treatment. FUTURE PLANS Further studies will provide detailed data regarding the quality of diagnosis and management of patients with PCa in Martinique; analysing quality of care will be the next challenge.Quality of life and patient outcomes will be evaluated using a digital platform for patient-reported outcome measurement and electronic records.
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Affiliation(s)
- Clarisse Joachim
- UF1441 Registre des cancers de la Martinique, Pôle de Cancérologie Hématologie Urologie Pathologie, CHU Martinique, Fort-de-France, Martinique
| | - Jacqueline Veronique-Baudin
- UF1441 Registre des cancers de la Martinique, Pôle de Cancérologie Hématologie Urologie Pathologie, CHU Martinique, Fort-de-France, Martinique
| | - Thierry Almont
- Groupe d’Étude, de Formation et de Recherche en Andrologie, Urologie et Sexologie Médecine de la Reproduction, Toulouse, France
- Groupe de recherche en fertilité humaine, CHU Toulouse Paule de Viguier, Toulouse, France
| | - Stephen Ulric-Gervaise
- UF1441 Registre des cancers de la Martinique, Pôle de Cancérologie Hématologie Urologie Pathologie, CHU Martinique, Fort-de-France, Martinique
| | - Jonathan Macni
- UF1441 Registre des cancers de la Martinique, Pôle de Cancérologie Hématologie Urologie Pathologie, CHU Martinique, Fort-de-France, Martinique
| | - Olivier Pierre-Louis
- Pôle de Cancérologie Hématologie Urologie Pathologie, CHU Martinique, Fort-de-France, Martinique
| | - Lidvine Godaert
- Pôle de Gériatrie, CHU de Martinique, Fort-de-France, Martinique
| | - Moustapha Drame
- Unité d’aide Méthodologique, Pôle Recherche et Santé publique, CHU de Reims, Reims, France
- EA 3797, Université de Reims Champagne-Ardenne, Faculté de Médecine, Reims, France
| | - Jean-Luc Novella
- EA 3797, Université de Reims Champagne-Ardenne, Faculté de Médecine, Reims, France
- Département de Médecine Interne et Gériatrie, CHU de Reims, Reims, France
| | - Karim Farid
- Service de Médecine nucléaire, Pole d’imagerie Médicale, CHU Martinique, Fort-de-France, Martinique
| | - Vincent Vinh-Hung
- Pôle de Cancérologie Hématologie Urologie Pathologie, CHU Martinique, Fort-de-France, Martinique
| | - Patrick Escarmant
- Pôle de Cancérologie Hématologie Urologie Pathologie, CHU Martinique, Fort-de-France, Martinique
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