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Benedict MO, Steinberg WJ, Claassen FM, Mofolo N. The profile of Black South African men diagnosed with prostate cancer in the Free State, South Africa. S Afr Fam Pract (2004) 2023; 65:e1-e10. [PMID: 36744484 PMCID: PMC9983285 DOI: 10.4102/safp.v65i1.5553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/06/2022] [Accepted: 06/24/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Prostate cancer (PCa) ranks high in terms of morbidity and mortality, especially in Africa. Prostate-specific antigen (PSA) screening remains a practical method of screening for and thereby detecting PCa early, especially among African men who are more negatively affected. Modifiable risk factors for PCa are mostly behavioural and lifestyle. Understanding community-specific determinants is important when developing health promotion interventions. OBJECTIVE This study aimed to determine the profile of African men with PCa in the Free State, South Africa. METHOD A cross-sectional descriptive study was conducted using case record information and self-administered questionnaires among 341 African men with PCa attending the oncology and urology clinics of a tertiary hospital. RESULT Participants' median age at diagnosis was 66 years. Only 76 (22.3%) participants had ever heard of PCa prior to being diagnosed with the disease, 36 (47.4%) of whom had ever had screening performed. The majority (n = 298, 87.4%) were symptomatic; 50% sought medical help within six months. At diagnosis, 133 (39.0%) men presented with stage T3 or T4 disease, 75 (22.0%) with metastatic disease and 84 (24.6%) with Gleason score ≥ 8. Factors associated with advanced and high-grade disease included smoking, decreased sunlight exposure and physical activity, relatively increased ingestion of dairy products and red meat. Factors associated with early stage and low-grade disease included relatively increased ingestion of fruits, vegetables and fish. CONCLUSION Advanced and high-grade PCa disease is not uncommon among men ≥ 60 years in this study setting. Certain modifiable risk factors associated with advanced disease were established in this study. The majority had lower urinary tract symptoms (LUTS) prior to PCa diagnosis, but they were of poor health-seeking behaviour. Although there seems not to be a systematic delay in the definitive diagnosis and initiation of treatment for PCa, there is a need to improve on health education and awareness in the study setting.
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Affiliation(s)
- Matthew O.A. Benedict
- Department of Family Medicine, Faculty of Health Sciences, School of Clinical Medicine, University of the Free State, Bloemfontein, South Africa
| | - Wilhelm J. Steinberg
- Department of Family Medicine, Faculty of Health Sciences, School of Clinical Medicine, University of the Free State, Bloemfontein, South Africa
| | - Frederik M. Claassen
- Department of Urology, Faculty of Health Sciences, School of Clinical Medicine, University of the Free State, Bloemfontein, South Africa
| | - Nathaniel Mofolo
- Faculty of Health Sciences, School of Clinical Medicine, University of the Free State, Bloemfontein, South Africa
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He H, Han D, Xu F, Lyu J. How socioeconomic and clinical factors impact prostate-cancer-specific and other-cause mortality in prostate cancer stratified by clinical stage: Competing-risk analysis. Prostate 2022; 82:415-424. [PMID: 34927741 DOI: 10.1002/pros.24287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 11/30/2021] [Accepted: 12/07/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND The aim of this study was to analyze the causes of death and risk factors of prostate-cancer-specific mortality (PCSM) and other-cause mortality (OCM) at different clinical stages using data from the Surveillance, Epidemiology, and End Results database. METHODS The characteristics and cause-specific death classifications of males with prostate cancer (PCa) were extracted. Multivariate competing-risk regression analysis was used to identify significant predictors and quantify the cumulative incidence of PCSM and OCM at different clinical stages. RESULTS Of the 244,433 PCa patients who were included, 19,274 died from 7356 PCSM, and 11,918 from OCM. The proportion of PCSM gradually increased from 2010 to 2016. The risk factors for PCSM in the localized PCa stage included older age, not being married, living in a county with higher poverty rates, and higher PSA levels and Gleason scores. Meanwhile, Medicaid and lower education levels were the additional risk factors of OCM. The risk factors for PCSM in the regional PCa stage included older age, not being married, Medicaid, living in a county with higher poverty rates, and higher PSA levels and Gleason scores. Meanwhile, the income level did not affect OCM risk. The risk factors for PCSM in the distant metastatic PCa stage included a separated/divorced/widowed marital status, Medicaid, and higher PSA levels and Gleason scores. Meanwhile, older age, an unmarried or separated/divorced/widowed marital status, and higher PSA levels were risk factors for OCM. In addition, receiving both surgery and radiation was worse than just receiving surgery for PCa specific survival in localized and regional PCa patients. CONCLUSION Some pretreatment and treatment factors may influence OCM that are not identical to those for PCSM at the corresponding stage. Decision-makers and managers should fully consider OCM to maximize treatment benefits for PCa.
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Affiliation(s)
- Hairong He
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Didi Han
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Fengshuo Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Jun Lyu
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
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Goksu SY, Ozer M, Beg MS, Sanford NN, Ahn C, Fangman BD, Goksu BB, Verma U, Sanjeevaiah A, Hsiehchen D, Jones AL, Kainthla R, Kazmi SM. Racial/Ethnic Disparities and Survival Characteristics in Non-Pancreatic Gastrointestinal Tract Neuroendocrine Tumors. Cancers (Basel) 2020; 12:cancers12102990. [PMID: 33076486 PMCID: PMC7602558 DOI: 10.3390/cancers12102990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/09/2020] [Accepted: 10/13/2020] [Indexed: 02/07/2023] Open
Abstract
Simple Summary The impact of race and ethnicity on survival characteristics in non-pancreatic gastrointestinal tract neuroendocrine tumors is understudied. We evaluated the survival outcomes and racial/ethnic disparities in the gastrointestinal tract neuroendocrine tumors, including the esophagus, stomach, small intestine, colon, rectum, and appendix. Survival trends were determined among three groups: Hispanic, non-Hispanic White, and non-Hispanic Black. We analyzed a large national database and found that race/ethnicity is an independent prognostic factor in patients with gastrointestinal neuroendocrine tumors. Hispanic patients had better overall survival than non-Hispanic White patients, whereas non-Hispanic Black patients had favorable cause-specific survival compared to non-Hispanic White patients. This survival disparity can be attributed to differences in the site of origin, age, and stage at presentation between various race/ethnicity. Understanding these differences between race and ethnicity is needed to reduce disparities in cancer outcomes. Abstract Background: We studied the effect of race and ethnicity on disease characteristics and survival in gastrointestinal neuroendocrine tumors. Methods: The Surveillance, Epidemiology, and End Results database was used to select patients with non-pancreatic gastrointestinal neuroendocrine tumors diagnosed between 2004 and 2015. Trends in survival were evaluated among three groups: Hispanic, non-Hispanic White, and non-Hispanic Black. Kaplan–Meier and Cox regression methods were performed to calculate overall survival and cause-specific survival after adjusting for patient and tumor characteristics. Results: A total of 26,399 patients were included in the study: 65.1% were non-Hispanic White, 19.9% were non-Hispanic Black, and 15% were Hispanic. Non-Hispanic White patients were more likely to be male (50.0%, p < 0.001), older than 60 years (48.0%, p < 0.001), and present with metastatic disease (17.7%, p < 0.001). Non-Hispanic White patients had small intestine neuroendocrine tumors, while Hispanic and non-Hispanic Black patients had rectum neuroendocrine tumors as the most common primary site. Hispanic patients had better overall survival, while non-Hispanic Black patients had better cause-specific survival versus non-Hispanic White patients. This finding was confirmed on multivariable analysis where Hispanic patients had improved overall survival compared to non-Hispanic White patients (Hazard ratio (HR): 0.89 (0.81–0.97)), whereas non-Hispanic Black patients had better cause-specific survival compared to non-Hispanic White patients (HR: 0.89 (0.80–0.98)). Conclusions: Race/ethnicity is an independent prognostic factor in patients with gastrointestinal neuroendocrine tumors.
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Affiliation(s)
- Suleyman Yasin Goksu
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX 75390, USA; (S.Y.G.); (M.S.B.); (B.D.F.); (B.B.G.); (U.V.); (A.S.); (D.H.); (A.L.J.); (R.K.)
- Division of Hematology and Oncology, UT Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Muhammet Ozer
- Division of Hematology and Oncology, UT Southwestern Medical Center, Dallas, TX 75390, USA;
- Department of Internal Medicine, Capital Health Regional Medical Center, Trenton, NJ 08638, USA
| | - Muhammad S. Beg
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX 75390, USA; (S.Y.G.); (M.S.B.); (B.D.F.); (B.B.G.); (U.V.); (A.S.); (D.H.); (A.L.J.); (R.K.)
- Division of Hematology and Oncology, UT Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Nina Niu Sanford
- Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Chul Ahn
- Department of Population and Data Sciences, UT Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Benjamin D. Fangman
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX 75390, USA; (S.Y.G.); (M.S.B.); (B.D.F.); (B.B.G.); (U.V.); (A.S.); (D.H.); (A.L.J.); (R.K.)
| | - Busra B. Goksu
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX 75390, USA; (S.Y.G.); (M.S.B.); (B.D.F.); (B.B.G.); (U.V.); (A.S.); (D.H.); (A.L.J.); (R.K.)
| | - Udit Verma
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX 75390, USA; (S.Y.G.); (M.S.B.); (B.D.F.); (B.B.G.); (U.V.); (A.S.); (D.H.); (A.L.J.); (R.K.)
- Division of Hematology and Oncology, UT Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Aravind Sanjeevaiah
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX 75390, USA; (S.Y.G.); (M.S.B.); (B.D.F.); (B.B.G.); (U.V.); (A.S.); (D.H.); (A.L.J.); (R.K.)
- Division of Hematology and Oncology, UT Southwestern Medical Center, Dallas, TX 75390, USA;
| | - David Hsiehchen
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX 75390, USA; (S.Y.G.); (M.S.B.); (B.D.F.); (B.B.G.); (U.V.); (A.S.); (D.H.); (A.L.J.); (R.K.)
- Division of Hematology and Oncology, UT Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Amy L. Jones
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX 75390, USA; (S.Y.G.); (M.S.B.); (B.D.F.); (B.B.G.); (U.V.); (A.S.); (D.H.); (A.L.J.); (R.K.)
- Division of Hematology and Oncology, UT Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Radhika Kainthla
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX 75390, USA; (S.Y.G.); (M.S.B.); (B.D.F.); (B.B.G.); (U.V.); (A.S.); (D.H.); (A.L.J.); (R.K.)
- Division of Hematology and Oncology, UT Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Syed M. Kazmi
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX 75390, USA; (S.Y.G.); (M.S.B.); (B.D.F.); (B.B.G.); (U.V.); (A.S.); (D.H.); (A.L.J.); (R.K.)
- Division of Hematology and Oncology, UT Southwestern Medical Center, Dallas, TX 75390, USA;
- Correspondence: ; Tel.: +1-214-648-4180
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Vengaloor Thomas T, Gordy XZ, Lirette ST, Albert AA, Gordy DP, Vijayakumar S, Vijayakumar V. Lack of Racial Survival Differences in Metastatic Prostate Cancer in National Cancer Data Base (NCDB): A Different Finding Compared to Non-metastatic Disease. Front Oncol 2020; 10:533070. [PMID: 33072567 PMCID: PMC7531281 DOI: 10.3389/fonc.2020.533070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 08/17/2020] [Indexed: 12/24/2022] Open
Abstract
Background: Inconsistent findings have been reported in the literature regarding racial differences in survival outcomes between African American and white patients with metastatic prostate cancer (mPCa). The current study utilized a national database to determine whether racial differences exist among the target population to address this inconsistency. Methods: This study retrospectively reviewed prostate cancer (PCa) patient data (N = 1,319,225) from the National Cancer Database (NCDB). The data were divided into three groupings based on the metastatic status: (1) no metastasis (N = 318,291), (2) bone metastasis (N = 29,639), and (3) metastases to locations other than bone, such as brain, liver, or lung (N = 952). Survival probabilities of African American and white PCa patients with bone metastasis were examined through parametric proportional hazards Weibull models and Bayesian survival analysis. These results were compared to patients with no metastasis or other types of metastases. Results: No statistically supported racial disparities were observed for African American and white men with bone metastasis (p = 0.885). Similarly, there were no racial disparities in survival for those men suffering from other metastases (liver, lung, or brain). However, racial disparities in survival were observed among the two racial groups with non-metastatic PCa (p < 0.001) or when metastasis status was not taken into account (p < 0.001). The Bayesian analysis corroborates the finding. Conclusion: This research supports our previous findings and shows that there are no racial differences in survival outcomes between African American and white patients with mPCa. In contrast, racial disparities in the survival outcome continue to exist among non-metastatic PCa patients. Further research is warranted to explain this difference.
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Affiliation(s)
- Toms Vengaloor Thomas
- Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS, United States
| | - Xiaoshan Z Gordy
- Department of Health Sciences, University of Mississippi Medical Center, Jackson, MS, United States
| | - Seth T Lirette
- Department of Data Science, University of Mississippi Medical Center, Jackson, MS, United States
| | - Ashley A Albert
- Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS, United States
| | - David P Gordy
- Department of Radiology, University of Mississippi Medical Center, Jackson, MS, United States
| | - Srinivasan Vijayakumar
- Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS, United States
| | - Vani Vijayakumar
- Department of Radiology, University of Mississippi Medical Center, Jackson, MS, United States
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5
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Okoro FO, Song L, Auten B, Whitaker-Brown C, Cornelius J. African-American survivors of prostate cancer: a meta-synthesis of qualitative studies. J Cancer Surviv 2020; 15:40-53. [PMID: 32666419 DOI: 10.1007/s11764-020-00909-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 06/22/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE The purpose of this study is to systematically review the current literature on the post-treatment survivorship experiences of African-American men with prostate cancer by exploring qualitative studies to gain a deep understanding of their survivorship experiences. METHOD We searched five databases for studies published from 2008 to 2018. We identified ten relevant qualitative studies, conducted a meta-synthesis using Noblit and Hare's meta-ethnography approach, and evaluated their quality appraisal using the validated Critical Appraisal Skills Program. RESULTS This review generated a total of four main themes and nine subthemes. The Four main themes included coping strategy, psychophysical impact, health system influence, and socioeconomic impact. Spirituality, healthy behaviors, supportive care of spouse/family/friends and non-communicating/reticent were subthemes identified in the coping strategy theme; physical well-being and sexuality and masculinity were subthemes in the psychophysical impact theme; healthcare provider interaction and treatment decision-making were subthemes identified in the health system influence theme, and health insurance status was the subtheme in the socioeconomic impact theme. CONCLUSION Our findings reveal that the experiences of African-American prostate cancer survivors are complex and multidimensional. IMPLICATIONS FOR CANCER SURVIVORS This review highlights the need for further studies with African-American prostate cancer survivors, precisely identify their needs and plan a culturally appropriate intervention to meet those needs.
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Affiliation(s)
- Florence Osita Okoro
- School of Nursing, The University of North Carolina at Charlotte, Charlotte, NC, 28223, USA.
| | - Lixin Song
- School of Nursing, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, UNC-CH, Chapel Hill, NC, 27599, USA
| | - Beth Auten
- J. Murrey Atkins Library, The University of North Carolina at Charlotte, Charlotte, NC, USA
| | | | - Judy Cornelius
- School of Nursing, The University of North Carolina at Charlotte, Charlotte, NC, 28223, USA
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6
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Tean O, Bras Da Silva C, Vega Toro P, Barre P, Molinie V, Ravery V. Épidémiologie du cancer de la prostate en Guyane française – Données préliminaires. Prog Urol 2020; 30:456-462. [DOI: 10.1016/j.purol.2020.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 02/21/2020] [Accepted: 05/12/2020] [Indexed: 12/20/2022]
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7
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Halabi S, Dutta S, Tangen CM, Rosenthal M, Petrylak DP, Thompson IM, Chi KN, Araujo JC, Logothetis C, Quinn DI, Fizazi K, Morris MJ, Eisenberger MA, George DJ, De Bono JS, Higano CS, Tannock IF, Small EJ, Kelly WK. Overall Survival of Black and White Men With Metastatic Castration-Resistant Prostate Cancer Treated With Docetaxel. J Clin Oncol 2018; 37:403-410. [PMID: 30576268 DOI: 10.1200/jco.18.01279] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Several studies have reported that among patients with localized prostate cancer, black men have a shorter overall survival (OS) time than white men, but few data exist for men with advanced prostate cancer. The primary goal of this analysis was to compare the OS in black and white men with metastatic castration-resistant prostate cancer (mCRPC) who were treated in phase III clinical trials with docetaxel plus prednisone (DP) or a DP-containing regimen. METHODS Individual participant data from 8,820 men with mCRPC randomly assigned in nine phase III trials to DP or a DP-containing regimen were combined. Race was based on self-report. The primary end point was OS. The Cox proportional hazards regression model was used to assess the prognostic importance of race (black v white) adjusted for established risk factors common across the trials (age, prostate-specific antigen, performance status, alkaline phosphatase, hemoglobin, and sites of metastases). RESULTS Of 8,820 men, 7,528 (85%) were white, 500 (6%) were black, 424 (5%) were Asian, and 368 (4%) were of unknown race. Black men were younger and had worse performance status, higher testosterone and prostate-specific antigen, and lower hemoglobin than white men. Despite these differences, the median OS was 21.0 months (95% CI, 19.4 to 22.5 months) versus 21.2 months (95% CI, 20.8 to 21.7 months) in black and white men, respectively. The pooled multivariable hazard ratio of 0.81 (95% CI, 0.72 to 0.91) demonstrates that overall, black men have a statistically significant decreased risk of death compared with white men ( P < .001). CONCLUSION When adjusted for known prognostic factors, we observed a statistically significant increased OS in black versus white men with mCRPC who were enrolled in these clinical trials. The mechanism for these differences is not known.
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Affiliation(s)
| | | | | | - Mark Rosenthal
- 3 The Royal Melbourne Hospital, Parkville, VIC, Australia
| | | | | | - Kim N Chi
- 6 BC Cancer Agency Vancouver Centre, Vancouver, BC
| | - John C Araujo
- 7 The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - David I Quinn
- 8 University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | | | | | - Mario A Eisenberger
- 11 The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | | | - Johann S De Bono
- 12 The Institute of Cancer Research and The Royal Marsden National Health Service Foundation Trust, Sutton, United Kingdom
| | | | - Ian F Tannock
- 13 Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Eric J Small
- 14 University of California San Francisco, San Francisco, CA
| | - William Kevin Kelly
- 15 Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, PA
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8
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Wallace TJ, Qian J, Avital I, Bay C, Man YG, Wellman LL, Moskaluk C, Troyer D, Ramnani D, Stojadinovic A. Technical Feasibility of Tissue Microarray (TMA) Analysis of Tumor-Associated Immune Response in Prostate Cancer. J Cancer 2018; 9:2191-2202. [PMID: 29937939 PMCID: PMC6010688 DOI: 10.7150/jca.22846] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Accepted: 04/28/2018] [Indexed: 11/22/2022] Open
Abstract
Introduction: The androgen receptor (AR) regulates immune-related epithelial-to-mesenchymal transition (EMT), and prostate cancer (PCa) metastasis. Primary tumor-infiltrating lymphocytes (TILs) [CD3+, CD4+, and CD8+ TILs] are potential prognostic indicators in PCa, and variations may contribute to racial disparities in tumor biology and PCa outcomes. Aim: To assess the technical feasibility of tumor microarray (TMA)-based methods to perform multi-marker TIL profiling in primary resected PCa. Methods: Paraffin-embedded tissue cores of histopathologically-confirmed primary PCa (n = 40; 1 TMA tissue specimen loss) were arrayed in triplicate on TMAs. Expression profiles of AR, CD3+, CD4+, and CD8+ TILs in normal prostate, and the center and periphery of both the tumor-dominant nodule and highest Gleason grade were detected by IHC and associated with clinical and pathological data using standard statistical methodology. An independent pathologist, blinded to the clinical data, scored all samples (percent and intensity of positive cells). Results: TMAs were constructed from 21 (53.8%) Black and 18 (46.2%) White males with completely-resected, primarily pT2 stage PCa [pT2a (n = 3; 7.7%); pT2b (n = 2; 5.1%); pT2c (n = 27; 69.2%); pT3a (n = 5; 12.8%); mean pre-op PSA = 8.17 ng/ml]. The CD3, CD4, CD8, and CD8/CD3 cellular protein expression differed from normal in the periphery of the dominant nodule, the center of the highest Gleason grade, and the periphery of the highest Gleason grade (P < 0.05). Correlations between TIL expression in the center and periphery of the dominant nodule, with corresponding center and periphery of the highest Gleason grade, respectively, were robust, and the magnitude of these correlations differed markedly by race (P < 0.05). Conclusions: Multi-marker (AR, CD3, CD4, CD8) profiling with IHC analysis of TMAs consisting of primary, non-metastatic resected prostate cancer is technically feasible in this pilot study. Future studies will evaluate primary tumor immunoscore using semi-quantitative, IHC-based methodology to assess differences in the spectrum, quantity, and/or localization of TILs, and to gain insights into racial disparities in PCa tumor biology and clinical outcomes.
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Affiliation(s)
| | - Junqi Qian
- Virginia Urology, Richmond, Virginia, U.S.A
| | - Itzhak Avital
- Soroka University Center for Advanced Cancer Care, Ber Sheva, Israel
| | - Curt Bay
- A.T. Still University, Mesa, Arizona, U.S.A
| | - Yan-Gao Man
- National Medical Centre of Colorectal Disease, Third Affiliated Hospital of Nanjing University of Traditional Chinese Medicine (TCM), Nanjing, China
| | | | - Chris Moskaluk
- University of Virginia, Charlottesville, Virginia, U.S.A
| | - Dean Troyer
- Eastern Virginia Medical School, Norfolk, Virginia, U.S.A
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9
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Ibraheem A, Polite B. Improving the accrual of racial and ethnic minority patients in clinical trials: Time to raise the stakes. Cancer 2017; 123:4752-4756. [DOI: 10.1002/cncr.31073] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 09/03/2017] [Accepted: 09/06/2017] [Indexed: 01/08/2023]
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