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. 2015 Apr;13(2):e65-72.
doi: 10.1016/j.clgc.2014.08.012. Epub 2014 Oct 25.

African-american race is a predictor of seminal vesicle invasion after radical prostatectomy

Kosj Yamoah  1 , Amy Walker  2 , Elaine Spangler  2 , Charnita M Zeigler-Johnson  3 , Bruce Malkowicz  2 , David I Lee  2 , Adam P Dicker  3 , Timothy R Rebbeck  2 , Priti Lal  2
Affiliations

African-american race is a predictor of seminal vesicle invasion after radical prostatectomy

Kosj Yamoah et al. Clin Genitourin Cancer. 2015 Apr.

Abstract

Introduction: The purpose of the study was to determine whether racial differences exist in the pattern of local disease progression among men treated with radical prostatectomy (RP) for localized prostate cancer (PCa), which is currently unknown. In this study we evaluated the pattern of adverse pathologic features in an identical cohort of African-American (AA) and Caucasian (CS) men with PCa.

Patients and methods: The overall cohort consisted of 1104 men (224 AA, and 880 CS) who underwent RP between 1990 and 2012. We compared preoperative factors and pathologic outcomes after RP across race groups. Multivariate analysis was used to identify factors predictive of adverse pathologic outcomes. The effect of race on adverse pathologic outcomes and biochemical control rate (BCR) was evaluated using multivariate regression model and Kaplan-Meier analysis.

Results: The 10-year BCR was 59% versus 82% in AA and CS men, respectively (P = .003). There was no significant difference in extraprostatic spread (P = .14), positive surgical margin (P = .81), lymph node involvement (P = .71), or adverse pathologic features (P = .16) across race groups. However, among patients with ≥ 1 adverse pathologic features, AA men had higher rate of seminal vesicle invasion (SVI) compared with CS men (51% vs. 30%; P = .01). After adjusting for known predictors of adverse pathologic features AA race remained a predictor of SVI.

Conclusion: AA men have an increased risk of SVI after RP, particularly among men with Gleason ≤ 6 disease. This might represent racial differences in the biology of PCa disease progression, which contribute to poorer outcomes in AA men.

Keywords: Adverse pathologic features invasion; African-American; Biochemical failure; Black men; Disparities; Prostate cancer; Seminal vesicle invasion.

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Conflict of interest statement

Disclaimer/Conflict of interest: none to disclose

Figures

FIG. 1
FIG. 1
(A) Distribution of adverse pathologic features by race, and (B) Kaplan-Meier curves for biochemical control rate by race in prostate cancer patients treated with radical prostatectomy at University of Pennsylvania, 1990–2012. Abbreviations: BCR- Biochemical control rate. ‡Adverse pathologic features: extraprostatic extension, seminal vesicle invasion, positive surgical margin and/or lymph node involvement.
See this image and copyright information in PMC

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