Racial differences in serum prostate-specific antigen (PSA) doubling time, histopathological variables and long-term PSA recurrence between African-American and white American men undergoing radical prostatectomy for clinically localized prostate cancer
Tewari, Ashutosh; Horninger, Wolfgang; Badani, Ketan K.; Hasan, Mazen; Coon, Steven; Crawford, E. David; Gamito, Eduard J.; Wei, John; Taub, David A.; Montie, James E.; Porter, Christopher; Divine, George W.; Bartsch, Georg; Menon, Mani
2005-07
Citation
Tewari, Ashutosh; Horninger, Wolfgang; Badani, Ketan K.; Hasan, Mazen; Coon, Steven; Crawford, E. David; Gamito, Eduard J.; Wei, John; Taub, David; Montie, James; Porter, Chris; Divine, George W.; Bartsch, Georg; Menon, Mani (2005). "Racial differences in serum prostate-specific antigen (PSA) doubling time, histopathological variables and long-term PSA recurrence between African-American and white American men undergoing radical prostatectomy for clinically localized prostate cancer." BJU International 96(1): 29-33. <http://hdl.handle.net/2027.42/74706>
Abstract
To determine if there are significant differences in biochemical characteristics, biopsy variables, histopathological data, and rates of prostate-specific antigen (PSA) recurrence between African-American (AA) and white American (WA) men undergoing radical prostatectomy (RP), as AA men are twice as likely to die from prostate cancer than their white counterparts. PATIENTS AND METHODS We established a cohort of 1058 patients (402 AA, 646 WA) who had RP and were followed for PSA recurrence. Age, race, serum PSA, biopsy Gleason score, clinical stage, pathological stage, and PSA recurrence data were available for the cohort. The chi-square test of proportions and t -tests were used to assess basic associations with race, and log-rank tests and Cox regression models for time to PSA recurrence. Forward stepwise variable selection was used to assess the effect on the risk of PSA recurrence for race, adjusted by the other variables added one at a time. RESULTS The AA men had higher baseline PSA levels, more high-grade prostatic intraepithelial neoplasia (HGPIN) in the biopsy, and more HGPIN in the pathology specimen than WA men. The AA men also had a shorter mean (sd) PSA doubling time before RP, at 4.2 (4.7) vs 5.2 (5.9) years. However, race was not an independent predictor of PSA recurrence ( P = 0.225). Important predictors for PSA recurrence in a multivariable model were biopsy HGPIN ( P < 0.014), unilateral vs bilateral cancer ( P < 0.006), pathology Gleason score and positive margin status (both P < 0.001). CONCLUSIONS This study indicates that while there are racial differences in baseline serum PSA and incidence of HGPIN, race is not an independent risk factor for PSA recurrence. Rather, other variables such as pathology Gleason score, bilateral cancers, HGPIN and margin positivity are independently associated with PSA recurrence. The PSA doubling time after recurrence may also be important, leading to the increased mortality of AA men with prostate cancer.Publisher
Blackwell Science Ltd
ISSN
1464-4096 1464-410X
Other DOIs
PMID
15963115
Types
Article
URI
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=15963115&dopt=citationMetadata
Show full item recordCollections
Remediation of Harmful Language
The University of Michigan Library aims to describe library materials in a way that respects the people and communities who create, use, and are represented in our collections. Report harmful or offensive language in catalog records, finding aids, or elsewhere in our collections anonymously through our metadata feedback form. More information at Remediation of Harmful Language.
Accessibility
If you are unable to use this file in its current format, please select the Contact Us link and we can modify it to make it more accessible to you.