Researchers have found no significant racial variation in the rates of prostate cancer (PCa) upstaging and upgrading at the time of radical prostatectomy among men with low-risk disease, according to a recent report. African Americans, however, are significantly more likely than other races to have positive surgical margins (PSM).
A team at the University of California San Francisco led by Matthew R. Cooperberg, MD, studied 4,231 patients with low-risk PCa based on initial biopsy findings. All had undergone with RP within 1 year of diagnosis. The group included 3,771 Caucasians, 273 African Americans, and 187 patients of other races.
The overall rate of pathologic upgrading and upstaging was 34% and 13%, respectively, and these rates did not differ significantly by racial group, the investigators reported online ahead of print in European Urology. The upgrading rates were 33%, 34%, and 33% for Caucasians, African Americans, and other races, respectively. The upstaging rates were 13%, 13%, and 16%, respectively. The PSM rate was 31% for African Americans versus 21% and 20% for Caucasians and other races. In multivariate analysis, African Americans were 63% and 41% more likely than Caucasians and other races to have PSM.
Additionally, African-American patients were significantly younger than Caucasians and other races (mean 58.7 years vs. 60.0 and 60.5 years) and more likely to have comorbidities such as hypertension and diabetes.