e16557 Background: In a previous wide-ranging study on the outcomes of prostate cancer patients at a safety-net hospital, we discovered significantly improved mortality outcomes for Haitian Creole prostate cancer patients compared to all other languages spoken, including black English speakers, with p = 0.017 [Rand, AE, et al., Clin Genitourin Cancer. (6):455-60 (2014)]. In order to assess any molecular indications that could be contributing to this finding, we performed a histological analysis of prostate cancer specimens, comparing black English-speaking patients to Haitian Creole patients. Methods: We sampled prostatectomies from 34 black English-speaking patients and 38 black Haitian Creole-speaking patients, taken between December 2011 and June 2015. In addition to primary and secondary Gleason scores, extraprostatic extension (EPE), seminal vesicle invasion (SVI), lymphovascular invasion (LVI), and perineural invasion (PNI), we observed any small amounts of grade 5 tissue present for the tertiary Gleason score. Finally, we analyzed the presence of acute and chronic inflammation and inflammatory severity. A chi square analysis was used to compare the categories between the Haitian and non-Haitian sets, with a probability less than 0.05 considered statistically significant. Results: While the null hypothesis was confirmed for primary, secondary, and total Gleason scores, 23.7% of the Haitian samples had a tertiary Gleason score of 5, compared to only 6.3% of non-Haitian samples (p = 0.046). The two populations exhibited similar rates of EPE (p = 0.719), SVI (p = 0.884), and PNI (p = 0.597), with no LVI apparent in any sample. No significant trends were noted in acute vs. chronic inflammation (p = 0.402) or severity of inflammation (p = 0.601). Conclusions: Samples taken from Haitian Creole-speaking patients had a significantly higher rate of grade 5 tertiary Gleason tissue than the non-Haitian patient samples. The presence of a tertiary Gleason score indicates a higher risk of metastasis, yet the Haitian samples do not reveal a greater rate of extraprostatic invasion. Further studies investigating underlying health factors among Haitian patients might be useful in accounting for improved patient outcomes.
e18073 Background: Disparities in breast cancer treatment and outcomes are recognized in the literature. We analyzed the association of patient demographics and tumor characteristics on the type of first treatment received at a diverse safety net medical center. Methods: 1,130 patients were diagnosed and treated for breast cancer between 2004 and 2014 at our institution. We retrospectively collected data on patient race/ethnicity, primary language, marital status, insurance coverage, age at diagnosis (years), AJCC stage, type of treatment, and hormone receptor status. Chi-square or Fisher’s exact test was performed to test for differences in categorical variables. Results: The distribution of first treatment received was as follows: surgery 80.5% (n = 910), chemotherapy (CT) 14.3% (n = 162), hormone therapy (HT) 5.1% (n = 58). Black patients were more likely to receive CT as a first treatment (19.3%) compared to White (10.2%), Hispanic (13.0%), or Other race patients (13.1%), p = 0.008. Patients with advanced AJCC stage (III- IV) were more likely to receive CT as a first treatment, stage III (48.6%), stage IV (36.4%), compared to earlier AJCC stage patients, p < 0.0001. ER-/PR-/HER2- patients were more likely to receive CT as a first treatment (30.8%) compared to ER+/PR+/HER2- patients (6.9%), p < 0.0001. Single patients were more likely to receive CT as a first treatment (18.1%) compared to married or other patients, p < 0.008. Patients with Medicaid/Charity insurance were more likely to receive CT as a first treatment (21.9%) compared to patients with other insurance, p < 0.0001. Younger patients ( < 50 years) were more likely to receive CT as a first treatment (24.9%) compared to older patients ( > 50 years), p < 0.0001. Haitian Creole and Other language speaking patients were more likely to receive CT as a first treatment (17.8%, 18% respectively) compared to other language speaking patients, p = 0.03. Conclusions: In this large retrospective analysis, patients more likely to receive CT as a first treatment were Black, had advanced AJCC stage, were ER-/PR-/HER2-, younger, unmarried, or had Medicaid/Charity insurance. Further research is needed to understand causes of disparities in the type of first treatment received for breast cancer and their impact on outcomes.
