OncologyDoes Race Affect Postoperative Outcomes in Patients With Low-Risk Prostate Cancer Who Undergo Radical Prostatectomy?
Section snippets
Material and Methods
We retrospectively reviewed the data from 2407 consecutive patients who had undergone radical retropubic prostatectomy at our institution from 1991 to 2007. We defined 2 cohorts of low-risk patients, 1 using liberal criteria (cohort 1), defined as those with a PSA level of ≤15 ng/mL, Gleason score ≤6, clinical Stage T1 or T2, and 1 or 2 positive cores on prostate needle biopsy, and the second using stringent criteria (cohort 2), defined as those with a PSA level ≤10 ng/mL, Gleason score ≤6,
Results
A total of 648 white and 91 African-American patients were included in cohort 1 and 354 white and 53 African-American patients were included in the cohort 2. No significant differences were found between white and African-American patients in age at diagnosis, mean PSA level, median follow-up, or percentage of biopsy cores involved with adenocarcinoma in either cohort. The only significant difference in preoperative characteristics was a greater mean body mass index for African-American
Comment
The introduction and widespread implementation of PSA screening for prostate cancer has resulted in a significant shift to the diagnosis of low-risk disease in younger men. Although risk stratification schemes such as those proposed by D'Amico et al.14 and the Memorial Sloan-Kettering group15 are helpful in counseling patients with regard to their risk of recurrence after treatment, few data are available to guide clinicians in counseling patients regarding the true risk of death from prostate
Conclusions
In our experience with patients with low-risk prostate cancer who underwent radical prostatectomy, no significant difference was found in prostate cancer-specific measures of disease control, risk of disease upgrading, estimated tumor volume, or recurrence-free survival between white and African-American men. Taken together, these data suggest that, despite the well-documented racial disparities in prostate cancer epidemiology and outcomes, no evidence exists that low-risk African-American
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This research was supported by the Linda and Joel Appel Prostate Cancer Research Fund.