Abstract
Background:
To investigate racial differences in tumor burden (cancer volume, cancer percentage and cancer to PSA ratios) in a large cohort of men undergoing radical prostatectomy (RP).
Methods:
Demographic, clinical and pathological data of patients undergoing RP between 1993–2010 were reviewed and compared between African-American (AA) and non African-American (nAA) men. Further assessments of pathological tumor burden (estimated tumor volume, percent of cancer involvement, and estimated tumor volume/PSA ratios) were performed across Gleason score categories.
Results:
Of 4157 patients in the analysis, 604 (14.5%) were AA. Overall, AA patients were younger, had higher Gleason scores, PSA levels and incidence of palpable disease (all P<0.001). Despite comparable prostate weights (39.4 vs. 39.6 g), AA men had higher percent cancer involvement and estimated tumor volume (all P<0.001) but similar estimated tumor volume/PSA ratios (P>0.05). When stratified by Gleason scores, prostate weights were comparable; however, estimated tumor volume, percent cancer involvement and estimated tumor volume/PSA ratios were higher in AA men with low grade (⩽6) prostate cancer (PCa), similar in intermediate grade (7–8) and lower in high grade (9-10) PCa compared to nAA men.
Conclusions:
In this large series, AA patients had higher disease burden (estimated tumor volume, percent cancer involvement, estimated tumor volume/PSA ratios) compared to nAA but this association was especially pronounced in low grade (Gleason ⩽6) cancers. These data depict a complex picture of relations between race and tumor burden across the spectrum of PCa aggressiveness. Further investigation is warranted to understand the mechanisms of racial disparities in PCa.
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Acknowledgements
LLB and LG supported by research was supported research funds from the Committee for Urologic Research, Education, and Development (CURED) of Duke University.
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Tsivian, M., Bañez, L., Keto, C. et al. African-American men with low-grade prostate cancer have higher tumor burdens: Results from the Duke Prostate Center. Prostate Cancer Prostatic Dis 16, 91–94 (2013). https://doi.org/10.1038/pcan.2012.39
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DOI: https://doi.org/10.1038/pcan.2012.39
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