Racial differences in prostate cancer (PCa) incidence and mortality are well known. The incidence of PCa is about 60% higher in African American (AA) men compared with white men, and mortality rates for AA men are 2-3 times greater. 1 However, there is controversy in the literature as to whether AA race is an independent predictor of adverse oncologic outcomes for patients with clinically localized PCa. 2,3 A prior study at our institution analyzed outcomes in 326 AA men and 4962 white men who had been treated with radical prostatectomy (RP) between 1988 and 2004 and found that there was no association between AA race and adverse pathologic features or biochemical recurrence (BCR). 4 </P>However, there is growing evidence that AA men with PCa may harbor more aggressive tumors. Sanchez-Ortiz et al 5 found that AA men with clinical stage T1c disease had higher postprostatectomy Gleason scores, greater cancer volume, and greater tumor volume per ng/mL of serum prostate-specific antigen (PSA) compared with matched white men. Synthesizing data from autopsy and surgical studies, Powell et al 6 have suggested that PCa in AA men, compared with white men, grows and progresses more rapidly with 4-fold increased rates of
Urology – Elsevier
Published: Dec 1, 2014
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