Mp70-02 Does Pre-Prostatectomy Magnetic Resonance Imaging Reduce Racial Disparities in Oncologic Outcomes for African American Patients: A Propensity Score-Matched Analysis

You have accessJournal of UrologyDiversity, Equity & Inclusion: Health Equity & Outcomes III (MP70)1 May 2024MP70-02 DOES PRE-PROSTATECTOMY MAGNETIC RESONANCE IMAGING REDUCE RACIAL DISPARITIES IN ONCOLOGIC OUTCOMES FOR AFRICAN AMERICAN PATIENTS: A PROPENSITY SCORE-MATCHED ANALYSIS Kyle C. Schuppe, Christopher Koller, Sahil Parikh, Charles Hesswani, William S. Azar, Sarah Azari, Alexander P. Kenigsberg, Nityam Rathi, Jason Hyman, David G. Gelikman, Neil Mendhiratta, Daniel Nethala, Sandeep Gurram, Maria Merino, Peter Choyke, Baris Turkbey, and Peter A. Pinto Kyle C. SchuppeKyle C. Schuppe , Christopher KollerChristopher Koller , Sahil ParikhSahil Parikh , Charles HesswaniCharles Hesswani , William S. AzarWilliam S. Azar , Sarah AzariSarah Azari , Alexander P. KenigsbergAlexander P. Kenigsberg , Nityam RathiNityam Rathi , Jason HymanJason Hyman , David G. GelikmanDavid G. Gelikman , Neil MendhirattaNeil Mendhiratta , Daniel NethalaDaniel Nethala , Sandeep GurramSandeep Gurram , Maria MerinoMaria Merino , Peter ChoykePeter Choyke , Baris TurkbeyBaris Turkbey , and Peter A. PintoPeter A. Pinto View All Author Informationhttps://doi.org/10.1097/01.JU.0001008796.84999.75.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prostate cancer disproportionately affects African American (AA) men. Prior long-term outcome research on racial oncologic disparities in prostate cancer was done before the widespread adoption of multiparametric MRI (mpMRI). We aim to determine whether these oncological inequalities can be minimized using a prostate mpMRI-based selection. METHODS: This study utilizes a prospectively maintained database to identify self-reported AA and non-AA patients who underwent robotic-assisted radical prostatectomy (RARP) between 2007 and 2023. Baseline characteristics, including age, pre-operative biopsy grade group (GG), and pre-operative PSA, MRI were used to propensity match AA patients with non-AA controls in a 1:3 ratio. Pathological information was obtained from RARP specimen and included extraprostatic extension (EPE), seminal vesicle invasion (SVI), lymphovascular invasion (LVI), perineural invasion (PNI), positive lymph nodes status and positive surgical margins (PSM). Final pathologic upgrading, oncologic outcomes including biochemical recurrence (BCR), metastasis-free survival (MFS), and overall survival (OS) were evaluated. RESULTS: The study identified 115 AA and 345 non-AA patients who underwent RARP and having undergone a preoperative mpMRI. Median follow-up was 60 months (IQR 22-113) for AA patients and 55 months (IQR 24-103) for non-AA patients (p=0.9). The sole significant finding of this was time to BCR was shorter in AA men than in non-AA controls (median 124 vs, 150 months, respectively, p=0.026). In contrast, there were no significant differences identified in oncologic outcomes of adverse pathology, including EPE, positive surgical margins or rate of positive lymph nodes (p>0.05). There were similar rates of pathologic upgrading from pre-operative MRI-fusion systematic and targeted biopsy to final path (10% AA vs 14% non-AA, p=0.3). Long-term, AA and non-AA patients had similar rates of MFS (96 vs. 96% at 5 yr, respectively, p=0.2) and OS (99 vs. 100% at 5 y, p=0.6). 34 (29.6%) AA patients versus 84 (24.3%) of non-AA controls experienced BCR (p=0.3). CONCLUSIONS: AA and non-AA patients preoperatively risk-stratified with mpMRI have similar 5-year oncological outcomes AA patients may have shorter BCR-free survival, although this is a delayed finding and may be related to previously described disparities in follow-up. Further follow-up is necessary to see if this decreased time to BCR will translate into shorter MFS and OS. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1128 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Kyle C. Schuppe More articles by this author Christopher Koller More articles by this author Sahil Parikh More articles by this author Charles Hesswani More articles by this author William S. Azar More articles by this author Sarah Azari More articles by this author Alexander P. Kenigsberg More articles by this author Nityam Rathi More articles by this author Jason Hyman More articles by this author David G. Gelikman More articles by this author Neil Mendhiratta More articles by this author Daniel Nethala More articles by this author Sandeep Gurram More articles by this author Maria Merino More articles by this author Peter Choyke More articles by this author Baris Turkbey More articles by this author Peter A. Pinto More articles by this author Expand All Advertisement PDF downloadLoading ...