Evidence map›Paper›PMID 32327702›Full record

Observational studyProstate cancer and prostatic diseases2020

African-American men with low-risk prostate cancer treated with radical prostatectomy in an equal-access health care system: implications for active surveillance.

Rishi Deka, J Kellogg Parsons, Daniel R Simpson, Paul Riviere, Vinit Nalawade, Lucas K Vitzthum, A Karim Kader, Christopher J Kane, Chelsea S Rock, James D Murphy and 1 more

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Prostate cancer and prostatic diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Observational
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 1 country.

Rishi DekaVA San Diego Health Care System, La Jolla, CA, USA. rdeka@ucsd.edu.
J Kellogg ParsonsDepartment of Urology, University of California San Diego School of Medicine, La Jolla, CA, USA.
Daniel R SimpsonVA San Diego Health Care System, La Jolla, CA, USA.
Paul RiviereVA San Diego Health Care System, La Jolla, CA, USA.ORCID http://orcid.org/0000-0001-7966-3090
Vinit NalawadeVA San Diego Health Care System, La Jolla, CA, USA.
Lucas K VitzthumVA San Diego Health Care System, La Jolla, CA, USA.
A Karim KaderDepartment of Urology, University of California San Diego School of Medicine, La Jolla, CA, USA.
Christopher J KaneDepartment of Urology, University of California San Diego School of Medicine, La Jolla, CA, USA.
Chelsea S RockVA San Diego Health Care System, La Jolla, CA, USA.
James D MurphyVA San Diego Health Care System, La Jolla, CA, USA.
Brent S RoseVA San Diego Health Care System, La Jolla, CA, USA.
UC San Diego Health System · USUniversity of California San Diego · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is concern that African-American men (AA) with low-risk prostate cancer may present with more aggressive disease and thus may not be candidates for active surveillance (AS). However, it is uncertain if poorer outcomes are due to disparities in access to medical care rather than true biological differences.

methodsObservational cohort study of patients diagnosed with low-risk PC-Gleason score ≤6, clinical tumor stage ≤2A, and prostate specific antigen (PSA) level ≤10-at US Department of Veterans Affairs between January 1, 2001 and October 31, 2015 and treated with radical prostatectomy. Outcomes included upgrading to Gleason Grade Group 2 (GG2), GG ≥ 3, PSA recurrence, pathologic tumor stage ≥3, positive surgical margins, and all-cause mortality.

resultsA total of 2857 men (AA: 835 White: 2022) with a median follow-up of 7.1 years. Overall, there was no significant difference between AA and White men in upgrading to GG ≥ 3 (RR = 1.18, p = 0.43), tumor stage ≥3 (RR = 0.95, p = 0.74), positive surgical margins (RR = 1.14, p = 0.20), PSA recurrence (SHR = 1.26, p = 0.06), and all-cause mortality (SHR = 1.26, p = 0.16). However, there was a significant increase in upgrading for AA to GG2 (RR = 1.49, p < 0.01).

conclusionsThere was no significant difference in most adverse pathologic outcomes between AA and White patients. However, GG2 upgrading was more common in AA men. The implication is that AA may need to undergo additional evaluation, such as a biopsy MRI, before initiating AS. Whether the increase in GG2 upgrading will lead to poorer long-term clinical outcomes such as metastasis and PCSM also requires further investigation.

Indexed as

Health Services AccessibilityBiopsyBlack or African AmericanBlack PeopleCohort StudiesHumansKallikreinsMaleMiddle AgedNeoplasm GradingNeoplasm Recurrence, LocalProstatectomyProstate-Specific AntigenProstatic NeoplasmsUnited StatesWatchful WaitingKallikreinsKLK3 protein, humanProstate-Specific Antigen

Identifiers

PMID32327702
OpenAlexW3019329527

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.