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Comparative Study
. 2017 Nov 14;12(11):e0186026.
doi: 10.1371/journal.pone.0186026. eCollection 2017.

Comparative rates of upstaging and upgrading in Caucasian and Korean prostate cancer patients eligible for active surveillance

Hwang Gyun Jeon  1 , Jae Ho Yoo  1 , Byong Chang Jeong  1 , Seong Il Seo  1 , Seong Soo Jeon  1 , Han-Yong Choi  1 , Hyun Moo Lee  1 , Michelle Ferrari  2 , James D Brooks  2 , Benjamin I Chung  2
Affiliations
Comparative Study

Comparative rates of upstaging and upgrading in Caucasian and Korean prostate cancer patients eligible for active surveillance

Hwang Gyun Jeon et al. PLoS One. .

Abstract

Purpose: To investigate the impact of race on the risk of pathological upgrading and upstaging at radical prostatectomy (RP) in an Asian (Korean) and Western (Caucasian) cohort eligible for active surveillance (AS).

Materials and methods: We performed a retrospective cohort study of 854 patients eligible for AS who underwent RP in United States (n = 261) and Korea (n = 593) between 2006 and 2015. After adjusting for age, PSA level, and prostate volume, we utilized multivariate logistic regression analysis to assess the effect of race on upgrading or upstaging.

Results: There were significant differences between Caucasian and Korean patients in terms of age at surgery (60.2 yr. vs. 64.1 yr.), PSA density (0.115 ng/mL/mL vs. 0.165 ng/mL/mL) and mean number of positive cores (3.5 vs. 2.4), but not in preoperative PSA values (5.11 ng/mL vs. 5.05 ng/mL). The rate of upstaging from cT1 or cT2 to pT3 or higher was not significantly different between the two cohorts (8.8% vs. 11.0%, P = 0.341). However, there were higher rates of upgrading to high-grade cancer (Gleason 4+3 or higher) in Korean patients (9.1%) when compared to Caucasian counterparts (2.7%) (P = 0.003). Multivariate logistic regression analysis showed that age (OR 1.07, P < 0.001) and smaller prostate volume (OR 0.97, P < 0.001), but not race, were significantly associated with upstaging or upgrading.

Conclusions: There were no differences in rates of upgrading or upstaging between Caucasian and Korean men eligible for active surveillance.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist

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