# Disparities in Outcomes in Latino Subpopulations with Localized Prostate Cancer Undergoing Radical Prostatectomy: A Population-Based Analysis

## TL;DR

This study shows that Mexican Latino men with prostate cancer have worse outcomes compared to other Latino and non-Hispanic White men after surgery.

## Contribution

The study highlights disparities in prostate cancer outcomes among disaggregated Latino subpopulations, emphasizing the need for more detailed ethnic categorization in cancer research.

## Key findings

- Mexican Latino patients had higher baseline PSA and worse survival rates compared to South/Central American and Caribbean Latino patients.
- Disaggregating Latino subpopulations revealed significant differences in cancer outcomes not evident when grouping all Latinos together.
- Mexican Latino patients had shorter 5- and 10-year overall and recurrence-free survival rates compared to non-Mexican Latino patients.

## Abstract

Prostate cancer is the most frequently diagnosed cancer among men, with Latino patients experiencing worse outcomes and more aggressive disease compared to non-Hispanic/Latino populations. In a retrospective review of 7084 patients with localized prostate cancer treated with radical prostatectomy, we found that Latino patients, compared to non-Hispanic White patients, were significantly younger at the time of surgery and had significantly higher median BMI, median baseline PSA, and D’Amico intermediate- and high-risk disease rates. Latino subpopulation analysis revealed that Mexican patients, compared to South/Central American and Caribbean patients, had higher median baseline PSA at presentation. Survival analysis revealed significantly shorter 5-year and 10-year overall survival and biochemical recurrence-free survival rates in Mexican Latinos. These findings underscore the importance of disaggregating the Latino population in cancer outcomes research.

Objectives: Prostate cancer is the most frequently diagnosed cancer among men, with Latino patients experiencing higher cancer-specific mortality compared to non-Hispanic populations. We evaluated prostate cancer outcomes across distinct Latino subpopulations. Methods: We retrospectively reviewed a single tertiary comprehensive cancer center database of patients with localized prostate cancer treated with radical prostatectomy from 2003 through 2020. Latino patients were subcategorized as Mexican, South/Central American (SCA), or Caribbean (Puerto Rico and Cuba). Non-Hispanic White (NHW) patients served as the reference group. Results: Overall, 7084 patients were included, of which 78% (n = 5518) were NHW and 10% (n = 679) were Latinos. Compared to NHW, Latino patients were younger at the time of surgery (median 62 vs. 64 years) and had higher median BMI (median 28.8 vs. 27.5 kg/m2), median baseline PSA (6.2 vs. 5.5 ng/mL), and D’Amico intermediate- (44% vs. 42%) and high-risk disease rates (16% vs. 13%) (all p < 0.001). Among Latino patients, Mexican patients had higher median baseline PSA (6.7 vs. 6.1 vs. 6.1 ng/mL, p = 0.005) compared to SCA and Caribbean patients. Survival analysis revealed shorter 5-year (97% vs. 99%) and 10-year (89% vs. 96%) overall survival (OS) rates in Mexican Latinos compared to non-Mexican Latinos (both p < 0.05). The 5-year (77% vs. 80% vs. 95%) and 10-year (63% vs. 65% vs. 86%) biochemical recurrence-free survival rates were shorter for Mexican patients compared to SCA and Caribbean patients. On multivariable analysis, SCA subpopulation status was associated with significantly better OS, and pathologic T stage > T2 was associated with worse biochemical recurrence-free survival. Conclusions: We identified significant differences in prostate cancer outcomes for different Latino subpopulations, underscoring the importance of population disaggregation in this ethnic group.