HisandHerHealth: Information About Sexuality, Prostate, Incontinence

IS ETHNICITY A PREDICTOR OF PROSTATE CANCER RECURRENCE FOLLOWING RADICAL PROSTATECTOMY? DATA FROM CAPSURE

Gary D Grossfeld*, David M Latini, Deborah P Lubeck, San Francisco, CA; Shilpa S Mehta, Lake Forest, IL; Peter R Carroll, San Francisco, CA

Prostate cancer incidence and mortality are higher in African-American than Caucasian men. We determined whether ethnicity is an independent predictor of disease recurrence in men who undergo radical prostatectomy. We studied age, race, prostate specific antigen (PSA) at diagnosis, clinical stage, biopsy Gleason score and the percent of positive biopsies at diagnosis in 1,468 men who underwent radical prostatectomy at the University of California, San Francisco or as part of the database of CaPSURE, a longitudinal disease registry of patients with prostate cancer. Disease recurrence was defined as a PSA of 0.2 ng./ml. or greater on 2 occasions after prostatectomy or cancer re-treatment at least 6 months after surgery. To control for pretreatment characteristics simultaneously, the men were assigned to previously described risk groups based on clinical stage, PSA at diagnosis and biopsy Gleason score. We assessed the likelihood of recurrence for each risk group according to ethnicity. Disease recurred in 304 of the 1,468 patients (21 percent). Age and clinical stage were not significant predictors of prostate cancer recurrence. African-American ethnicity was an independent predictor of recurrence when the men were stratified into risk groups. Ethnicity was most important in high risk patients. In high risk Caucasian men median survival was 6.27 years, while it was 4.27 years in high risk African-American men. Ethnicity appears to be an independent predictor of recurrence in community patients who undergo prostatectomy. This predictor appears to be particularly important in men with high risk disease.