San Diego, CA USA (UroToday.com) It is well know that African American (AA) men have an increased burden of prostate cancer, especially in regards to high risk prostate cancer. However, few studies have explored the role of Active Surveillance (AC) for AA men with low-risk prostate cancer. Investigators from UCSF retrospectively analyzed 895 men with clinically low risk prostate cancer (Gleason 3+3, c≤T2a, PSA ≤10 ng/mL) through the SEARCH database with special attention to AA and Caucasian men.
355 AA and 540 Caucasian men were identified meeting the inclusion criteria within the Shared Equal Access Regional Cancer Hospital (SEARCH) database. AA men were found to be statistically significantly younger at diagnosis (59.5 yrs vs. 62.0 years) and have a higher median PSA (5.5 vs. 5.1) compared to Caucasian men. In logistical regression models, Odds ratios for Gleason upgrade (≥3+4), major upgrade (≥4+3), upstage (pT3a or higher), positive surgical margins were all not statistically significant between AA and Caucasian patients. There were no differences in 5-year recurrence free survival rates between races (log-rank 0.178).
This study helped illuminate understanding of low risk prostate cancer in AA and thus the reliability of active surveillance in this demographic group. The results suggest that AA, compared to Caucasian race, is not a significant factor in pathological upgrade, major upgrade, upstaging, positive surgical margins, 5-year recurrence-free survival rates, or biochemical recurrence after radical prostatectomy. The investigators still support consideration of upgrading and upstaging for all men being managed by active surveillance.
Presented By: Michael Leapman, MD
Written By: Blanca Morales; Department of Urology, University of California, Irvine at the 2016 AUA Annual Meeting - May 6 - 10, 2016 – San Diego, California, USA