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.
