Mp68-07 Proportion of Gleason 8-10 Prostate Cancer Found on Biopsy and Tumor Aggressiveness in Matched Cohorts of Men in Asia and Western Countries

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History II (MP68)1 May 2024MP68-07 PROPORTION OF GLEASON 8-10 PROSTATE CANCER FOUND ON BIOPSY AND TUMOR AGGRESSIVENESS IN MATCHED COHORTS OF MEN IN ASIA AND WESTERN COUNTRIES Liang Dong, Katherine Lajkosz, Rafael Sanchez-Salas, Raj Vikesh Tiwari, Caio Pasquali Dias dos Santos, Baijun Dong, Jiahua Pan, Amy Chan, Dixon Woon, Girish S. Kulkarni, Nathan Perlis, Rob Hamilton, Laurence Klotz, Christopher J. D. Wallis, Petr Macek, Jack Tay Kae, Ants Toi, Antonio Finelli, Neil E. Fleshner, Xavier Cathelineau, Theodorus H. van der Kwast, Wei Xue, and Alexandre R. Zlotta Liang DongLiang Dong , Katherine LajkoszKatherine Lajkosz , Rafael Sanchez-SalasRafael Sanchez-Salas , Raj Vikesh TiwariRaj Vikesh Tiwari , Caio Pasquali Dias dos SantosCaio Pasquali Dias dos Santos , Baijun DongBaijun Dong , Jiahua PanJiahua Pan , Amy ChanAmy Chan , Dixon WoonDixon Woon , Girish S. KulkarniGirish S. Kulkarni , Nathan PerlisNathan Perlis , Rob HamiltonRob Hamilton , Laurence KlotzLaurence Klotz , Christopher J. D. WallisChristopher J. D. Wallis , Petr MacekPetr Macek , Jack Tay KaeJack Tay Kae , Ants ToiAnts Toi , Antonio FinelliAntonio Finelli , Neil E. FleshnerNeil E. Fleshner , Xavier CathelineauXavier Cathelineau , Theodorus H. van der KwastTheodorus H. van der Kwast , Wei XueWei Xue , and Alexandre R. ZlottaAlexandre R. Zlotta View All Author Informationhttps://doi.org/10.1097/01.JU.0001008744.60568.e8.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prostate Cancer (PCa) unevenly affects populations across the globe. Historically, Asia had a lower incidence and mortality of PCa compared with Western countries, but the gap appears to be narrowing in recent years. Paradoxically, Asian men have been reported to present with more advanced disease at presentation, though with more favorable outcomes, than men of European ancestry. METHODS: This retrospective cohort study included men who underwent prostate biopsy at University Centers in Shanghai, China and Toronto, Canada and radical prostatectomy (RP) in Shanghai, Singapore, Paris and Toronto in 2014-2019. Aggressive PCa on biopsy was defined as Gleason Score (GS) ≥8. A blind pathology review was performed to assess differences in scoring between centers. The proportion of men with GS ≥8 on biopsy and metastasis-free survival (MFS) and castration resistant prostate cancer-free survival (CRPC-FS) after RP for GS ≥8 PCa were compared in Asian and Western cohorts. Multivariable logistic regression and Cox proportional hazards models were performed. Propensity-score-matching was used to reduce imbalances between cohorts. RESULTS: 8722 men who were biopsied and 474 (282 Asian, 192 Westerners) operated by RP were included. PCa was found in 2343/4905 (48%) among men in Shanghai and 2373/3817 (65%) in Toronto (p<0.001), respectively. The proportion of men with GS ≥8 (15% vs 8.7%) on biopsy was significantly higher in Shanghai than Toronto (p<.001). However, when adjusting for age, PSA levels, prostate volume, number of positive cores and year of biopsy, there was no difference between matched cohorts of Asians and Westerners in the proportion of GS ≥8 on biopsy both in men with PSA <10 ng/ml (n=2760, OR 1.05 95% CI 0.74, 1.48, p=0.49) or PSA <20 ng/ml (n=4000, OR 0.95, 95% CI 0.72, 1.27, p=0.73). In matched cohorts operated by RP, the 5-year distant MFS rates were 80% (95% CI 73-89%) in men of Asian ancestry in Singapore and Shanghai vs 82% (95% CI 75-90%) in Toronto and Paris. No statistically significant difference was found after RP between matched cohorts of Asian and Westerners for the 5-year MFS (HR 0.97, 95% CI 0.55-1.70, p=.92) and 5-year CRPC-FS (HR 0.57, 95% CI 0.23-1.41, p=0.22). CONCLUSIONS: Contrary to previous assumptions, Asian men are equally likely to be found with aggressive PCa on biopsy than matched Westerners at PSA levels <20 ng/ml with no difference in disease aggressiveness after RP. The assumption that unfavorable PCa is less aggressive in Asians should be revisited. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1110 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Liang Dong More articles by this author Katherine Lajkosz More articles by this author Rafael Sanchez-Salas More articles by this author Raj Vikesh Tiwari More articles by this author Caio Pasquali Dias dos Santos More articles by this author Baijun Dong More articles by this author Jiahua Pan More articles by this author Amy Chan More articles by this author Dixon Woon More articles by this author Girish S. Kulkarni More articles by this author Nathan Perlis More articles by this author Rob Hamilton More articles by this author Laurence Klotz More articles by this author Christopher J. D. Wallis More articles by this author Petr Macek More articles by this author Jack Tay Kae More articles by this author Ants Toi More articles by this author Antonio Finelli More articles by this author Neil E. Fleshner More articles by this author Xavier Cathelineau More articles by this author Theodorus H. van der Kwast More articles by this author Wei Xue More articles by this author Alexandre R. Zlotta More articles by this author Expand All Advertisement PDF downloadLoading ...