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Black race does not independently predict adverse outcome following radical retropubic prostatectomy at a tertiary referral center.
J Urol. 2006 Aug; 176(2):515-9.JU

Abstract

PURPOSE

There is controversy in the literature as to whether black race is associated with poorer oncological outcomes among men undergoing radical prostatectomy for clinically localized prostate cancer. To address this issue we examined the outcomes of a cohort of black and white men treated by multiple surgeons at our institution.

MATERIALS AND METHODS

The study population consisted of 4,962 white and 326 black men treated with anatomical radical retropubic prostatectomy between 1988 and 2004 by 10 different surgeons at the Johns Hopkins Hospital, a tertiary care referral center. We evaluated the association between race and adverse pathological features, and biochemical progression.

RESULTS

Black men had significantly higher preoperative serum prostate specific antigen (mean 7.2 vs 6.0 ng/ml, p <0.001), body mass index (median 27.4 vs 26.3 kg/m, p <0.001) and incidence of higher grade disease (Gleason sum 4 + 3 or greater) on prostate biopsy (17% vs 14%, p = 0.011). After adjustment for multiple clinical variables there was no statistically significant association between race and the adverse pathological characteristics of high grade disease, positive surgical margins, extraprostatic extension or seminal vesicle invasion. Black race was associated with a significantly increased risk of biochemical progression on univariate analysis (HR 1.52, 95% CI 1.16-2.00, p = 0.002). However, after adjusting for clinical and pathological characteristics, black race was not an independent predictor of biochemical progression (HR 1.09, 95% CI 0.81-1.45, p = 0.578).

CONCLUSIONS

Black men were more likely to be obese and present with adverse preoperative clinical features at a younger age, and have a higher rate of biochemical progression. However, on multivariate analysis black race was not an independent predictor of adverse pathological outcome or biochemical recurrence. Further efforts are needed to detect prostate cancer earlier among black men.

Authors+Show Affiliations

Department of Urology, The Johns Hopkins School of Medicine, Baltimore, Maryland 21287, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

16813880

Citation

Nielsen, Matthew E., et al. "Black Race Does Not Independently Predict Adverse Outcome Following Radical Retropubic Prostatectomy at a Tertiary Referral Center." The Journal of Urology, vol. 176, no. 2, 2006, pp. 515-9.
Nielsen ME, Han M, Mangold L, et al. Black race does not independently predict adverse outcome following radical retropubic prostatectomy at a tertiary referral center. J Urol. 2006;176(2):515-9.
Nielsen, M. E., Han, M., Mangold, L., Humphreys, E., Walsh, P. C., Partin, A. W., & Freedland, S. J. (2006). Black race does not independently predict adverse outcome following radical retropubic prostatectomy at a tertiary referral center. The Journal of Urology, 176(2), 515-9.
Nielsen ME, et al. Black Race Does Not Independently Predict Adverse Outcome Following Radical Retropubic Prostatectomy at a Tertiary Referral Center. J Urol. 2006;176(2):515-9. PubMed PMID: 16813880.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Black race does not independently predict adverse outcome following radical retropubic prostatectomy at a tertiary referral center. AU - Nielsen,Matthew E, AU - Han,Misop, AU - Mangold,Leslie, AU - Humphreys,Elizabeth, AU - Walsh,Patrick C, AU - Partin,Alan W, AU - Freedland,Stephen J, PY - 2005/09/11/received PY - 2006/7/4/pubmed PY - 2006/8/30/medline PY - 2006/7/4/entrez SP - 515 EP - 9 JF - The Journal of urology JO - J. Urol. VL - 176 IS - 2 N2 - PURPOSE: There is controversy in the literature as to whether black race is associated with poorer oncological outcomes among men undergoing radical prostatectomy for clinically localized prostate cancer. To address this issue we examined the outcomes of a cohort of black and white men treated by multiple surgeons at our institution. MATERIALS AND METHODS: The study population consisted of 4,962 white and 326 black men treated with anatomical radical retropubic prostatectomy between 1988 and 2004 by 10 different surgeons at the Johns Hopkins Hospital, a tertiary care referral center. We evaluated the association between race and adverse pathological features, and biochemical progression. RESULTS: Black men had significantly higher preoperative serum prostate specific antigen (mean 7.2 vs 6.0 ng/ml, p <0.001), body mass index (median 27.4 vs 26.3 kg/m, p <0.001) and incidence of higher grade disease (Gleason sum 4 + 3 or greater) on prostate biopsy (17% vs 14%, p = 0.011). After adjustment for multiple clinical variables there was no statistically significant association between race and the adverse pathological characteristics of high grade disease, positive surgical margins, extraprostatic extension or seminal vesicle invasion. Black race was associated with a significantly increased risk of biochemical progression on univariate analysis (HR 1.52, 95% CI 1.16-2.00, p = 0.002). However, after adjusting for clinical and pathological characteristics, black race was not an independent predictor of biochemical progression (HR 1.09, 95% CI 0.81-1.45, p = 0.578). CONCLUSIONS: Black men were more likely to be obese and present with adverse preoperative clinical features at a younger age, and have a higher rate of biochemical progression. However, on multivariate analysis black race was not an independent predictor of adverse pathological outcome or biochemical recurrence. Further efforts are needed to detect prostate cancer earlier among black men. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/16813880/Black_race_does_not_independently_predict_adverse_outcome_following_radical_retropubic_prostatectomy_at_a_tertiary_referral_center_ L2 - https://www.jurology.com/doi/full/10.1016/j.juro.2006.03.100?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -