Prostate Cancer Characteristics in a Multiracial Community

To investigate the hypothesis that Northern Africans differ from Caucasians with regard to their PCa characteristics, using our 1988–2006 database we retrospectively reviewed the preoperative and pathological features of consecutive patients subjected to radical prostatectomy (RP) for localized prostate cancer (PCa) and stratified according to their ethnic origin. In 727 consecutive patients (616 Caucasians; 61 Blacks originating from Central Africa and the French West Indies; 50 Northern Africans from Morocco, Algeria, Tunisia), we preoperatively analyzed and compared age, clinical stage of the tumour, prostate-specific antigen (PSA), transrectal ultrasound prostate volume, PSA density (PSAD), biopsy Gleason score, number of positive cores (NPC), and percentage of tissue core invaded by cancer (PTIC); postoperatively, we determined the status of the capsule, seminal vesicles, and margins of the RP specimen, as well as Gleason score and prostate weight. Statistical analyses (chi-square test and ANOVA) were performed to compare the results between the three groups of patients. A multivariate analysis was carried out to test the independence of variables. Black patients were the youngest at the time of surgery (by 3–4 yr) and had the highest rates of final Gleason score ≥ 8. The Northern Africans had more favourable features than did Caucasian and Black patients: mean PTIC was 7.1% versus 14.6% and 12.5%, respectively (p = 0.005), mean NPC was 26.4% versus 34.7% and 36.4%, respectively (p = 0.034), rates of biopsy and final Gleason score ≥ 8 were significantly lower (p = 0.02 and p = 0.028, respectively), and there were positive margins in 26% versus 36% and 35.6%, respectively (p > 0.05). This study showed that a French Black population is the most likely of those studied to have unfavourable PCa characteristics at the time of RP. Albeit in a limited series, we show for the first time that Northern Africans have significantly better features in this regard than Caucasians and Blacks. Although Northern Africans did not have a better pathological stage outcome, they did have a more favourable Gleason score.