Presentation Authors: Marieke Johanna Krimphove*, Sean Anthony Fletcher, Alexander Putnam Cole, Sebastian Berg, Maxine Sun, Stuart R. Lipsitz, Brandon A. Mahal, Paul L. Nguyen, Toni K. Choueiri, Adam S. Kibel, Boston, MA, Luis A. Kluth, Frankfurt, Germany, Joel S. Weissmann, Quoc-Dien Trinh, Boston, MA
Introduction: To investigate quality of care at minority-serving hospitals (MSH) compared to other institutions for men with localized intermediate and high-risk prostate cancer (PCa).
Methods: We identified 536,539 men aged â‰¥40 years presenting with localized intermediate and high-risk PCa in the United States between 2004-2015 using the National Cancer Database (NCDB). Institutions were ranked according to the proportion of Black and Hispanic patients treated at a given institution, and the top decile institutions were defined as MSH. We used multivariable analyses to characterize the association between MSH and three endpoints: receipt of definitive treatment, time to definitive treatment, and receipt of androgen deprivation therapy in young (â‰¤65 years) and healthy (no comorbidity) men treated with external beam radiation therapy.
Results: 162 and 1168 hospitals were defined as MSH and non-MSH, respectively. In multivariable analyses, MSH was associated with decreased odds of receiving definitive treatment (Adjusted Odds Ratio [AOR] 0.73 95%-CI: 0.62 - 0.85, p < 0.001). The adjusted mean time to treatment was significantly longer in MSHs compared to non-MSHs (4.9days, standard error 2.2; p=0.024). Among young and healthy men, there was no association between treatment at MSH and receipt of androgen deprivation therapy in conjunction with external beam radiation (AOR 0.90; 95%-CI: 0.75 - 1.09, p=0.291).
Conclusions: Treatment at MSH was associated with lower odds of receiving definitive therapy and longer time to definitive therapy for localized intermediate- and high-risk PCa, despite adjustment for race. This suggests that some of the racial disparities in PCa may be explained by the sites at which racial/ethnic minorities receive care.
Source of Funding: Brigham Research Institute, Bruce A. Beal and Robert L. Beal Surgical Fellowship, Conquer Cancer Foundation, Defense Health Agency, Intuitive Surgical, Prostate Cancer Foundation, Vattikuti Urology Institute. Maxine Sun is supported by an American Urologi