Prostate specific antigen progression after radical prostatectomy in African‐American men versus White men

• Published in: Cancer 2002-05, Vol.94 (10), p.2577-2583
• Main Authors: Banerjee, Mousumi, Powell, Isaac J., George, Julie, Biswas, Debjit, Bianco, Fernando, Severson, Richard K.
• Format: Article
• Language: English
• Subjects: Adult; African Americans; Aged; biochemical recurrence; Biological and medical sciences; European Continental Ancestry Group; Humans; Male; Medical sciences; Middle Aged; Neoplasm Recurrence, Local; progression; prostate specific antigen (PSA); Prostate-Specific Antigen - blood; Prostatectomy; Prostatic Neoplasms - blood; race; radical prostatectomy; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the genital tract and mammary gland; Time Factors
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.10535

BACKGROUND It is well established that African‐American men (AAM) have a worse mortality from prostate carcinoma (PC) than White men (WM). Outcome data for men treated with radical prostatectomy for clinically localized PC demonstrate more advanced tumors and higher biochemical recurrence rates among AAM compared with WM. The objective of the current study was to characterize the pattern of prostate specific antigen (PSA) progression by race in patients experiencing disease recurrence after undergoing radical prostatectomy. Racial differences in the pattern of rising PSA would warrant different intervention strategies for reducing the disproportionality in survival outcomes between the two racial groups. METHODS Between 1991–1996, 1080 consecutive men underwent radical prostatectomy for clinically localized PC at Wayne State University‐affiliated Harper Hospital. Two hundred forty‐one patients developed a biochemical recurrence on or before January, 1, 1999. The median follow‐up was 39 months. Longitudinal PSA profiles of 77 men who met the study inclusion criteria were analyzed. Average relative velocities of PSA were compared between AAM and WM. Linear mixed effects regression was used to test the hypothesis that, after adjusting for age, preoperative PSA, stage and grade of disease, PSA levels increase at a faster rate in AAM compared with WM. RESULTS The mean average relative velocity for AAM and WM experiencing a disease recurrence was 0.25 ng/mL and 0.11 ng/mL per month, respectively (P = 0.21). The relative rate of PSA increase in patients who developed a disease recurrence after radical prostatectomy was 18.9% per month for AAM and 16.3% per month for WM (P = 0.73). CONCLUSIONS AAM and WM appear to have similar rates of PSA progression after undergoing radical prostatectomy. Cancer 2002;94:2577–83. © 2002 American Cancer Society. DOI 10.1002/cncr.10535 The current study examines ethnic differences in prostate specific antigen (PSA) progression rates after radical prostatectomy for clinically localized prostate carcinoma. Results of analyses based on longitudinal modeling of serial PSA profiles indicate that African‐American men and white men have similar rates of PSA progression.