Objectives
To assess the magnitude of racial disparities in prostate cancer outcomes following
radical prostatectomy for low-risk prostate cancer.
Methods
We retrospectively reviewed our database of 2407 patients who under went radical prostatectomy
and isolated 2 cohorts of patients with low-risk prostate cancer. Cohort 1 was defined
using liberal criteria, and cohort 2 was isolated using more stringent criteria. We
then studied pre- and postoperative parameters to discern any racial differences in
these 2 groups. Statistical analyses, including log-rank, χ2, and Fisher's exact analyses, were used to ascertain the significance of such differences.
Results
Preoperatively, no significant differences were found between the white and African-American
patients with regard to age at diagnosis, mean prostate-specific antigen, median follow-up,
or percentage of involved cores on prostate biopsy. African-American patients in cohort
1 had a greater mean body mass index than did white patients (26.9 vs 27.8, P = .026). The analysis of postoperative data demonstrated no significant difference
between white and African-American patients in the risk of biochemical failure, extraprostatic
extension, seminal vesicle involvement, positive surgical margins, tumor volume, or
risk of disease upgrading. African-American patients in cohort 2 demonstrated greater
all-cause mortality compared with their white counterparts (9.4% vs 3.1%, P = .027).
Conclusions
In patients with low-risk prostate cancer treated with radical prostatectomy, there
exist no significant differences in surrogate measures of disease control, risk of
disease upgrading, estimated tumor volume, or recurrence-free survival between whites
and African-Americans.
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Article info
Publication history
Published online: December 18, 2008
Accepted:
September 11,
2008
Received:
May 10,
2008
Footnotes
This research was supported by the Linda and Joel Appel Prostate Cancer Research Fund.
Identification
Copyright
© 2009 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
