Is Race Predictive of Biochemical Recurrence Following Radical Prostatectomy? A Study in a Latin-American Country
Athanase Billis, Luciana Meirelles, Leandro LLL Freitas, Ana KS Uejo, Heveline Covre, Marcelo VB Mota, Luis A Magna, Leonardo O Reis, Ubirajara Ferreira. School of Medicine, University of Campinas (Unicamp), Campinas, SP, Brazil
Background: It is controversial whether race is an independent predictor of biochemical recurrence following radical prostatectomy (RP). The aim of this study was to compare African-Brazilians vs. Whites in clinicopathological features and prostate-specific antigen (PSA) recurrence after surgery from a public and equal-access medical care. This is the first study from a South-American country.
Design: From 400 RP a mean of 32 paraffin blocks were processed from prostate surgical specimens step-sectioned at 3 to 5mm intervals from 322 (80.5%) Whites and 78 (19.5%) African-Brazilians submitted to RP from 1997 to 2010. This racial proportion is similar to the population of the South of Brazil. The clinicopathological features studied were: age, weight of the prostate, preoperative PSA, clinical stage (T1c/T2), surgical margin status, Gleason score on needle prostatic biopsy, Gleason score on RP, tumor extent on RP using a point-count semiquantitative method, and seminal vesicle invasion. Time to biochemical recurrence following RP was analyzed with the Kaplan-Meier product-limit analysis using the log-rank test for comparison between the groups and prediction of time to biochemical recurrence using univariate and multivariate Cox proportional hazards model.
Results: No significant difference was found comparing African-Brazilians vs. Whites related to age (p=0.622), weight of the prostate (p=0.782), preoperative PSA (p=0.085), clinical stage (p=0.314), surgical margin status (p=0.613), Gleason score on needle prostatic biopsy (p=0.375), Gleason score on RP (p=0.471), tumor extent on RP (p=0.535), and seminal vesicle invasion (p=0.676). There was no statistically significant difference to time of biochemical recurrence comparing the two groups (log-rank, p=0.572). Using Cox proportional hazards model, race was not predictive of time to biochemical recurrence neither in univariate analysis (p=0.575) nor in multivariate analysis (p=0.605). In our cohort of patients preoperative PSA (p=0.015), Gleason score on needle biopsies (p=0.048), positive surgical margins (p<0.001), and seminal vesicle invasion (p=0.012) were independent predictors of biochemical recurrence.
Conclusions: Race in Brazil (African-Brazilians vs Whites) seems to have no influence on clinicopathological features and biochemical recurrence following RP.
Category: Genitourinary (including renal tumors)
Wednesday, March 6, 2013 9:30 AM
Poster Session V # 129, Wednesday Morning