摘要
No AccessJournal of UrologyAdult urology1 Aug 2006Black Race Does Not Independently Predict Adverse Outcome Following Radical Retropubic Prostatectomy at a Tertiary Referral Centeris accompanied byThe E-Cadherin −160 C/A Polymorphism and Prostate Cancer Risk in White and Black American MenRadical Prostatectomy—Which Patients Benefit Most From Surgery? Matthew E. Nielsen, Misop Han, Leslie Mangold, Elizabeth Humphreys, Patrick C. Walsh, Alan W. Partin, and Stephen J. Freedland Matthew E. NielsenMatthew E. Nielsen Department of Urology, The Johns Hopkins School of Medicine, Baltimore, Maryland , Misop HanMisop Han Northwestern University Feinberg School of Medicine, Chicago, Illinois , Leslie MangoldLeslie Mangold Department of Urology, The Johns Hopkins School of Medicine, Baltimore, Maryland , Elizabeth HumphreysElizabeth Humphreys Department of Urology, The Johns Hopkins School of Medicine, Baltimore, Maryland , Patrick C. WalshPatrick C. Walsh Department of Urology, The Johns Hopkins School of Medicine, Baltimore, Maryland , Alan W. PartinAlan W. Partin Department of Urology, The Johns Hopkins School of Medicine, Baltimore, Maryland , and Stephen J. FreedlandStephen J. Freedland Department of Urology, The Johns Hopkins School of Medicine, Baltimore, Maryland View All Author Informationhttps://doi.org/10.1016/j.juro.2006.03.100AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: There is controversy in the literature as to whether black race is associated with poorer oncological outcomes among men undergoing radical prostatectomy for clinically localized prostate cancer. To address this issue we examined the outcomes of a cohort of black and white men treated by multiple surgeons at our institution. Materials and Methods: The study population consisted of 4,962 white and 326 black men treated with anatomical radical retropubic prostatectomy between 1988 and 2004 by 10 different surgeons at the Johns Hopkins Hospital, a tertiary care referral center. We evaluated the association between race and adverse pathological features, and biochemical progression. Results: Black men had significantly higher preoperative serum prostate specific antigen (mean 7.2 vs 6.0 ng/ml, p <0.001), body mass index (median 27.4 vs 26.3 kg/m2, p <0.001) and incidence of higher grade disease (Gleason sum 4 + 3 or greater) on prostate biopsy (17% vs 14%, p = 0.011). After adjustment for multiple clinical variables there was no statistically significant association between race and the adverse pathological characteristics of high grade disease, positive surgical margins, extraprostatic extension or seminal vesicle invasion. Black race was associated with a significantly increased risk of biochemical progression on univariate analysis (HR 1.52, 95% CI 1.16-2.00, p = 0.002). However, after adjusting for clinical and pathological characteristics, black race was not an independent predictor of biochemical progression (HR 1.09, 95% CI 0.81–1.45, p = 0.578). Conclusions: Black men were more likely to be obese and present with adverse preoperative clinical features at a younger age, and have a higher rate of biochemical progression. However, on multivariate analysis black race was not an independent predictor of adverse pathological outcome or biochemical recurrence. Further efforts are needed to detect prostate cancer earlier among black men. References 1 : SEER Cancer Statistics Review 1973-1998. Bethesda, Maryland: National Cancer Institute, National Institutes of Health2001. Google Scholar 2 : Recent trends in mortality rates for four major cancers, by sex and race/ethnicity—United States, 1990-1998. 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Google Scholar © 2006 by American Urological AssociationFiguresReferencesRelatedDetailsCited byMitin T, Chen M, Zhang Y, Moran B, Dosoretz D, Katin M, Braccioforte M, Salenius S and D'Amico A (2011) Diabetes Mellitus, Race and the Odds of High Grade Prostate Cancer in Men Treated With Radiation TherapyJournal of Urology, VOL. 186, NO. 6, (2233-2238), Online publication date: 1-Dec-2011.Uhlman M, Sun L, Stackhouse D, Polascik T, Mouraviev V, Robertson C, Albala D and Moul J (2010) Tumor Percent Involvement Predicts Prostate Specific Antigen Recurrence After Radical Prostatectomy Only in Men With Smaller ProstateJournal of Urology, VOL. 183, NO. 3, (997-1002), Online publication date: 1-Mar-2010.Freedland S (2007) Obesity and Prostate Cancer: Importance of Race and Stage of DiseaseJournal of Urology, VOL. 178, NO. 5, (1842-1843), Online publication date: 1-Nov-2007.Related articlesJournal of Urology9 Nov 2018The E-Cadherin −160 C/A Polymorphism and Prostate Cancer Risk in White and Black American MenJournal of Urology9 Nov 2018Radical Prostatectomy—Which Patients Benefit Most From Surgery? Volume 176Issue 2August 2006Page: 515-519 Advertisement Copyright & Permissions© 2006 by American Urological AssociationKeywordsobesityprostatic neoplasmscontinental population groupsprostatectomyprostate-specific antigenMetricsAuthor Information Matthew E. Nielsen Department of Urology, The Johns Hopkins School of Medicine, Baltimore, Maryland More articles by this author Misop Han Northwestern University Feinberg School of Medicine, Chicago, Illinois More articles by this author Leslie Mangold Department of Urology, The Johns Hopkins School of Medicine, Baltimore, Maryland More articles by this author Elizabeth Humphreys Department of Urology, The Johns Hopkins School of Medicine, Baltimore, Maryland More articles by this author Patrick C. Walsh Department of Urology, The Johns Hopkins School of Medicine, Baltimore, Maryland More articles by this author Alan W. Partin Department of Urology, The Johns Hopkins School of Medicine, Baltimore, Maryland More articles by this author Stephen J. Freedland Department of Urology, The Johns Hopkins School of Medicine, Baltimore, Maryland More articles by this author Expand All Advertisement PDF downloadLoading ...