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Race Per Se Does Not Predict Extracapsular Prostate Cancer

Race Per Se Does Not Predict Extracapsular Prostate Cancer

WASHINGTON—Surgeons have historically had a "feeling that black
men are at the highest risk" of bad outcomes in prostate cancer, said
Christopher R. Porter, MD, professor of urology, Stony Brook Hospital
Medical Center, Stony Brook, New York. Their risk of dying from the disease
is twice that of white men, and their risk of developing it is 1.7 times
higher.

But, Dr. Porter reported at the 8th Biennial Symposium on Minorities, the
Medically Underserved, and Cancer, race per se is not a factor in
predicting non-organ-confined disease in men with clinically localized
cancers.

He described a retrospective study of 207 men with clinically localized
prostate cancer, two thirds black and one third white, who had radical
prostatectomies at the same veterans medical center over the course of a
decade.

To identify predictive factors, a single pathologist who has specialized
training in urological oncology examined all of the pathological specimens.

Parameters included PSA, age, race, income, clinical stage, primary
Gleason grade, Gleason sum, percentage of total biopsy cores that were
positive, history of previous biopsy, and presence of prostatic
intraepithelial neoplasia and perineural invasion.

Two Factors Predictive

Of the clinical and histological criteria, only a PSA level of 10 ng/mL
or more and a percentage of positive biopsies of 40 or higher proved
predictive of extracapsular disease. Race was not predictive—a result that
differs from that of many other studies, Dr. Porter said.

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