MP60-12 DOES LARGER TUMOR VOLUME EXPLAIN THE HIGHER PROSTATE SPECIFIC ANTIGEN LEVELS IN BLACK MEN WITH PROSTATE CANCER —RESULTS FROM THE SEARCH DATABASE

Abstract

You have accessJournal of UrologyProstate Cancer: Detection and Screening II1 Apr 2015MP60-12 DOES LARGER TUMOR VOLUME EXPLAIN THE HIGHER PROSTATE SPECIFIC ANTIGEN LEVELS IN BLACK MEN WITH PROSTATE CANCER —RESULTS FROM THE SEARCH DATABASE Zachary Klaassen, Lauren E. Howard, Martha K. Terris, William J. Aronson, Matthew R. Cooperberg, Christopher L. Amling, Christopher J. Kane, and Stephen J. Freedland Zachary KlaassenZachary Klaassen More articles by this author , Lauren E. HowardLauren E. Howard More articles by this author , Martha K. TerrisMartha K. Terris More articles by this author , William J. AronsonWilliam J. Aronson More articles by this author , Matthew R. CooperbergMatthew R. Cooperberg More articles by this author , Christopher L. AmlingChristopher L. Amling More articles by this author , Christopher J. KaneChristopher J. Kane More articles by this author , and Stephen J. FreedlandStephen J. Freedland More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2214AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Multiple population-based studies have shown that black men have higher PSA values. Additionally, PSA is associated with larger prostate size and larger tumor size. We previously showed that the racial differences in PSA values are not explained by differences in prostate weight. An alternative explanation for higher PSA values among black men with prostate cancer may be increased tumor volume (TV). Thus, we assessed whether larger TV in black men explains the higher PSA levels in black versus white men with prostate cancer. METHODS We retrospectively analyzed 2099 men from the SEARCH database who underwent radical prostatectomy from 1990 to 2013. The associations between race and the outcome variables of TV and preoperative PSA values were examined using linear regression. We adjusted for center, age, surgery year, pathologic Gleason sum, positive margins, extracapsular extension, seminal vesicle invasion, and lymph node metastasis. Adjusted median and interquartile range of TV and PSA were calculated by back-transforming the predicted logarithmic values from the linear regression models. RESULTS There were 1236 (59%) white men and 863 (41%) black men. Black men were younger at surgery (60.3 vs. 63.1 years, p<0.001) had a higher preoperative PSA value (6.9 vs. 6.1 ng/mL, p<0.001), and more often had positive margins (48 vs. 38%, p<0.001) and seminal vesicle invasion (14 vs. 11%, p=0.03). White patients had worse clinical stage disease (p<0.001) and greater median TV (6.3 vs. 5.4 gm, p=0.004). After adjusting for demographics and cancer-specific characteristics, white men had a greater adjusted median TV (5.7 vs. 4.7 gm, p=0.02). However, when also adjusted for PSA, there was no racial difference in adjusted median TV (p=0.53). After adjusting for demographic and cancer-specific characteristics, black men had a higher median preoperative PSA compared to white men (7.5 vs. 6.1 ng/mL, p<0.001). To assess whether this difference was due to TV, we repeated the analysis of PSA but also adjusted for TV and again there was a significant difference in median preoperative PSA with black men having a 21% higher median preoperative PSA versus white men (7.4 vs. 6.1 ng/mL, p<0.001). CONCLUSIONS In this study of men undergoing radical prostatectomy at multiple equal access medical centers, TV did not explain the higher PSA levels in black versus white men. These results suggest that black men may have an inherent genetic profile that predisposes to higher PSA values regardless of demographic and clinicopathologic factors. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e742 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Zachary Klaassen More articles by this author Lauren E. Howard More articles by this author Martha K. Terris More articles by this author William J. Aronson More articles by this author Matthew R. Cooperberg More articles by this author Christopher L. Amling More articles by this author Christopher J. Kane More articles by this author Stephen J. Freedland More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...