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World Journal of Urology

, Volume 36, Issue 8, pp 1233–1239 | Cite as

Association between race and oncologic outcome following radical prostatectomy for clinically organ-confined prostate cancer: a long-term follow-up study

  • Erfan Amini
  • Tracy Campanelli Palmer
  • Jie Cai
  • Gary Lieskovsky
  • Siamak Daneshmand
  • Hooman Djaladat
Original Article

Abstract

Purpose

Few studies have evaluated prostate cancer oncologic outcomes in different ethnic groups following radical prostatectomy for clinically organ-confined disease. Existing studies lack long-term outcome data. We conducted this study to assess the impact of racial differences on risk profile and oncologic outcomes in a large cohort of patients with prostate cancer who underwent radical prostatectomy.

Methods

Using our institutional review board-approved prostate cancer database, we retrospectively reviewed the records of 3437 patients who underwent radical prostatectomy with curative intent in our institution between 1987 and 2009. Based on ethnicity, patients were divided into Asian Americans (n = 133), African Americans (n = 155) and Caucasians (n = 3149). Baseline characteristics and oncologic outcomes including biochemical recurrence free, clinical recurrence free and overall survival were compared between the study groups.

Results

A total of 3437 patients with a mean age of 63 ± 9.8 years and median follow-up period of 8.7 (range 0.1–24.1) years were included in the analysis. Pathologic stage and the frequency of poorly differentiated cancer were higher in Asian Americans; however, margin status did not differ significantly. Moreover, oncologic outcomes were comparable between different ethnic groups. In multivariate analysis, both pathologic stage and grade were independent predictors of oncologic outcomes, but race was not.

Conclusions

In this large, ethnically diverse long-term follow-up study, we noted that Asian Americans compared to African Americans and Caucasians are more likely to have high risk prostate cancer; however, race was not an independent predictor of oncologic outcome following radical prostatectomy with curative intent.

Keywords

Ethnic groups Prostatic neoplasms Race Recurrence Survival 

Notes

Authors’ contribution

EA, TCP, JC and HD were involved in project development and statistical analysis. EA, GL, SD and HD were involved in manuscript writing/editing. EA, TCP, JC, GL, SD and HD were involved in data management.

Compliance with ethical standards

Conflict of interest

Nothing to disclose.

Ethical approval

All patients included in this study had provided informed consent.

References

  1. 1.
    Siegel RL, Miller KD, Jemal A (2017) Cancer statistics, 2017. CA Cancer J Clin 67(1):7–30CrossRefPubMedGoogle Scholar
  2. 2.
    Kelly SP, Rosenberg PS, Anderson WF, Andreotti G, Younes N, Cleary SD, Cook MB (2017) Trends in the incidence of fatal prostate cancer in the United States by race. Eur Urol 71(2):195–201CrossRefPubMedGoogle Scholar
  3. 3.
    Faisal FA, Sundi D, Tosoian JJ, Choeurng V, Alshalalfa M, Ross AE, Klein E, Den R, Dicker A, Erho N, Davicioni E, Lotan TL, Schaeffer EM (2016) Racial variations in prostate cancer molecular subtypes and androgen receptor signaling reflect anatomic tumor location. Eur Urol 70(1):14–17CrossRefPubMedGoogle Scholar
  4. 4.
    Powell IJ, Bock CH, Ruterbusch JJ, Sakr W (2010) Evidence supports a faster growth rate and/or earlier transformation to clinically significant prostate cancer in black than in white American men, and influences racial progression and mortality disparity. J Urol 183(5):1792–1796CrossRefPubMedGoogle Scholar
  5. 5.
    Lichtensztajn DY, Gomez SL, Sieh W, Chung BI, Cheng I, Brooks JD (2014) Prostate cancer risk profiles of Asian-American men: disentangling the effects of immigration status and race/ethnicity. J Urol 191(4):952–956CrossRefPubMedGoogle Scholar
  6. 6.
    Sundi D, Ross AE, Humphreys EB, Han M, Partin AW, Carter HB, Schaeffer EM (2013) African American men with very low-risk prostate cancer exhibit adverse oncologic outcomes after radical prostatectomy: should active surveillance still be an option for them? J Clin Oncol 31(24):2991–2997CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Jalloh M, Myers F, Cowan JE, Carroll PR, Cooperberg MR (2015) Racial variation in prostate cancer upgrading and upstaging among men with low-risk clinical characteristics. Eur Urol 67(3):451–457CrossRefPubMedGoogle Scholar
  8. 8.
    Bolton DM, Papa N, Ta AD, Millar J, Davidson AJ, Pedersen J, Syme R, Patel MI, Giles GG (2015) Predictors of prostate cancer specific mortality after radical prostatectomy: 10 year oncologic outcomes from the Victorian Radical Prostatectomy Registry. BJU Int 116(Suppl 3):66–72CrossRefPubMedGoogle Scholar
  9. 9.
    Robbins AS, Koppie TM, Gomez SL, Parikh-Patel A, Mills PK (2007) Differences in prognostic factors and survival among white and Asian men with prostate cancer, California, 1995–2004. Cancer 110(6):1255–1263CrossRefPubMedGoogle Scholar
  10. 10.
    Tosoian JJ, Almutairi F, Morais CL, Glavaris S, Hicks J, Sundi D, Humphreys E, Han M, De Marzo AM, Ross AE, Tomlins SA, Schaeffer EM, Trock BJ, Lotan TL (2017) Prevalence and prognostic significance of PTEN loss in African-American and European-American men undergoing radical prostatectomy. Eur Urol 71(5):697–700CrossRefPubMedGoogle Scholar
  11. 11.
    de Jong FH, Oishi K, Hayes RB, Bogdanowicz JF, Raatgever JW, van der Maas PJ, Yoshida O, Schroeder FH (1991) Peripheral hormone levels in controls and patients with prostatic cancer or benign prostatic hyperplasia: results from the Dutch-Japanese case-control study. Cancer Res 51(13):3445–3450PubMedGoogle Scholar
  12. 12.
    Lookingbill DP, Demers LM, Wang C, Leung A, Rittmaster RS, Santen RJ (1991) Clinical and biochemical parameters of androgen action in normal healthy Caucasian versus Chinese subjects. J Clin Endocrinol Metab 72(6):1242–1248CrossRefPubMedGoogle Scholar
  13. 13.
    Ross RK, Bernstein L, Lobo RA, Shimizu H, Stanczyk FZ, Pike MC, Henderson BE (1992) 5-alpha-reductase activity and risk of prostate cancer among Japanese and US white and black males. Lancet 339(8798):887–889CrossRefPubMedGoogle Scholar
  14. 14.
    Ross R, Bernstein L, Judd H, Hanisch R, Pike M, Henderson B (1986) Serum testosterone levels in healthy young black and white men. J Natl Cancer Inst 76(1):45–48PubMedGoogle Scholar
  15. 15.
    Zeigler-Johnson CM, Spangler E, Jalloh M, Gueye SM, Rennert H, Rebbeck TR (2008) Genetic susceptibility to prostate cancer in men of African descent: implications for global disparities in incidence and outcomes. Can J Urol 15(1):3872–3882PubMedPubMedCentralGoogle Scholar
  16. 16.
    Takahashi H, Epstein JI, Wakui S, Yamamoto T, Furusato B, Zhang M (2014) Differences in prostate cancer grade, stage, and location in radical prostatectomy specimens from United States and Japan. Prostate 74(3):321–325CrossRefPubMedGoogle Scholar
  17. 17.
    Clegg LX, Li FP, Hankey BF, Chu K, Edwards BK (2002) Cancer survival among US whites and minorities: a SEER (surveillance, epidemiology, and end results) program population-based study. Arch Intern Med 162(17):1985–1993CrossRefPubMedGoogle Scholar
  18. 18.
    Du XL, Fang S, Coker AL, Sanderson M, Aragaki C, Cormier JN, Xing Y, Gor BJ, Chan W (2006) Racial disparity and socioeconomic status in association with survival in older men with local/regional stage prostate carcinoma: findings from a large community-based cohort. Cancer 106(6):1276–1285CrossRefPubMedGoogle Scholar
  19. 19.
    Freedland SJ, Jalkut M, Dorey F, Sutter ME, Aronson WJ (2000) Race is not an independent predictor of biochemical recurrence after radical prostatectomy in an equal access medical center. Urology 56(1):87–91CrossRefPubMedGoogle Scholar
  20. 20.
    Resnick MJ, Canter DJ, Guzzo TJ, Brucker BM, Bergey M, Sonnad SS, Wein AJ, Malkowicz SB (2009) Does race affect postoperative outcomes in patients with low-risk prostate cancer who undergo radical prostatectomy? Urology 73(3):620–623CrossRefPubMedGoogle Scholar
  21. 21.
    Faisal FA, Sundi D, Cooper JL, Humphreys EB, Partin AW, Han M, Ross AE, Schaeffer EM (2014) Racial disparities in oncologic outcomes after radical prostatectomy: long-term follow-up. Urology 84(6):1434–1441CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Powell IJ, Dyson G, Land S, Ruterbusch J, Bock CH, Lenk S, Herawi M, Everson R, Giroux CN, Schwartz AG, Bollig-Fischer A (2013) Genes associated with prostate cancer are differentially expressed in African American and European American men. Cancer Epidemiol Biomark Prev 22(5):891–897CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.The Institute of Urology, Norris Comprehensive Cancer CenterUniversity of Southern CaliforniaLos AngelesUSA
  2. 2.Department of Urology, Uro-oncology Research CenterTehran University of Medical SciencesTehranIran

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