EURURO Vol. 72 No. 2

313 320

combination with advanced inference model building,
should minimize the effects of confounding . We also
performed a sensitivity analysis using propensity score
adjustment and noted no substantial differences in the
model outputs. Fourth, although we present the results of
several statistical tests, we have not adjusted for multiple
comparisons. While we did not address multiplicity of
comparisons, our primary analysis was specified a priori
and we have been careful to interpret the results in the
context of clinical relevance in addition to statistical
significance .
Despite these limitations, we believe that our findings
provide a valuable framework for a more comprehensive
understanding of the effects of treatment and how these
effects relate conditionally to race/ethnicity. While our
study demonstrated that AA men have a higher risk of
incontinence at 1 yr after RP, especially minimally invasive
RP, these differences were not observed in the sexual,
bowel, urinary irritative, and hormone domains. With
longer follow-up, these data will lay a foundation for
decision support tools targeting patients and/or providers.
5. Conclusions
Unlike oncologic outcomes, the effect of treatment on
patient-reported function does not vary dramatically by
race/ethnicity. While long-term follow-up is needed to fully
characterize how these interactive effects will evolve over
time, these data will lay a foundation for decision support
tools targeting patients and/or providers.
Author contributions: Mark D. Tyson had full access to all the data in the
study and takes responsibility for the integrity of the data and the accuracy
of the data analysis.
Study concept and design: Penson, Barocas, Tyson.
Acquisition of data: Wu, Cooperberg, Goodman, Greenfield, Hamilton,
Hashibe, Paddock, Stroup, Chen.
Analysis and interpretation of data:[1_TD$DIFF] Alvarez, Koyama, Tyson, Barocas,
Penson.
Drafting of the manuscript: Tyson.
Critical revision of the manuscript for important intellectual content:
Barocas, Penson, Resnick, Hoffman, Wu, Goodman, Greenfield, Hamilton,
Hashibe, Paddock, Stroup, Chen.
Statistical analysis:[1_TD$DIFF] Alvarez, Koyama.
Obtaining funding: Penson.
Administrative, technical, or material support:[1_TD$DIFF] Alvarez.
Supervision: Barocas, Penson.
Other: None.
Financial disclosures: Mark D. Tyson certifies that all conflicts of interest,
including specific financial interests and relationships and affiliations
relevant to the subject matter or materials discussed in the manuscript
(eg, employment/affiliation, grants or funding, consultancies, honoraria,
stock ownership or options, expert testimony, royalties, or patents filed,
received, or pending), are the following: None.
Funding/Support and role of the sponsor: This work was supported by the
National Cancer Institute at the National Institutes of Health
(5T32CA106183 to M.D.T.); by the American Cancer Society (MSRG-
15-103-01-CPHPS to M.J.R.); by the US Agency for Healthcare Research
and Quality (1R01HS019356, 1R01HS022640-01); and through a
contract from the Patient-Centered Outcomes Research Institute. The
sponsors played a role in data collection.
Appendix A. Supplementary data
Supplementary data associated with this article can be
found, in the online version, at
.
References
[1]
.
[2] Oakley-Girvan I, Kolonel LN, Gallagher RP, Wu AH, Felberg A,
Whittemore AS. Stage at diagnosis and survival in a multiethnic
cohort of prostate cancer patients. Am J Public Health 2003;
93:1753–9 .
[3] Yamoah K, Stone N, Stock R. Impact of race on biochemical disease
recurrence after prostate brachytherapy. Cancer 2011;117:5589–
600 .
[4] Cohen JH, Schoenbach VJ, Kaufman JS, et al. Racial differences in
clinical progression among Medicare recipients after treatment for
localized prostate cancer (United States). Cancer Causes Control
2006;17:803–11
[5] Freeman VL, Durazo-Arvizu R, Keys LC, Johnson MP, Schafernak K,
Patel VK. Racial differences in survival among men with prostate
cancer and comorbidity at time of diagnosis. Am J Public Heal
2004;94:803–8 .
[6]
.
[7] Hoffman KE, Alvarez J, Barocas DA, et al. Distinct side effect profiles
after contemporary treatment of localized prostate cancer.
American Urological Association Annual Meeting 2015. Abstract
MP27-11.
[8] Johnson TK, Gilliland FD, Hoffman RM, et al. Racial/ethnic differ-
ences in functional outcomes in the 5 years after diagnosis of
localized prostate cancer. J Clin Oncol 2004;22:4193–201
.
[9]
.
[10] Barocas DA, Chen V, Cooperberg M, et al. Using a population-based
observational cohort study to address difficult comparative effec-
tiveness research questions: the CEASAR study. J Comp Eff Res
2013;2:445–60
[11]
[12] Skolarus TA, Dunn RL, Sanda MG, et al. Minimally important
difference for the expanded prostate cancer index composite short
form. Urology 2015;85:101–6
[13] Stier DM, Greenfield S, Lubeck DP, et al. Quantifying comorbidity in
a disease-specific cohort: adaptation of the total illness burden
index to prostate cancer. Urology 1999;54:424–9
[14] Litwin MS, Greenfield S, Elkin EP, Lubeck DP, Broering JM, Kaplan
SH. Assessment of prognosis with the total illness burden index for
E U R O P E A N U R O L O G Y 7 2 ( 2 0 1 7 ) 3 0 7 – 3 1 4 313