You have accessJournal of UrologyProstate Cancer: Epidemiology and Natural History II1 Apr 2012347 COMPARISON OF PATHOLOGICAL OUTCOMES OF RADICAL PROSTATECTOMY IN AFRICAN AMERICANS AND CAUCASIANS WHO ARE POTENTIAL CANDIDATES FOR ACTIVE SURVEILLANCE Mihailo Popovic and Steven M. Lucas Mihailo PopovicMihailo Popovic Detroit, MI More articles by this author and Steven M. LucasSteven M. Lucas Detroit, MI More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.408AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES While active surveillance is safe in appropriately selected patients, there is little data to show whether African Americans, who may represent a higher risk population, have equivalent outcomes as other racial groups. We compared pathological outcomes of African Americans and Caucasians who underwent radical prostatectomy but were candidates for active surveillance. METHODS A retrospective database review was conducted on patients that underwent radical prostatectomy between June, 1990 and March, 2011. Patients were potential candidates for active surveillance if their biopsy Gleason scores were 6 or less and clinical stage T2a or less. Intermediate risk patients were considered to have either stage T2b or Gleason score 3+4. At radical prostatectomy, the rates of Gleason upgrading and pathological upstaging were compared between Caucasians and African Americans. Comparisons of nominal variables were conducted using Chi square analysis. RESULTS Out of 3,037 radical prostatectomy patients, the median age was 61.8y. A total of 1,444 (47.5%) were Caucasian, 1,416 (46.6%) African American, and 177 (5.8%) other. A total of 1,139 (37.5%) were potential candidates for active surveillance following biopsy, and 761 (25.1%) were intermediate risk. Caucasians more frequently met the criteria than African Americans (40.0% vs. 35.5%, p=0.03). At radical prostatectomy, Caucasians and African Americans demonstrated a similar rate of Gleason upgrading: 334/570 (58.6%) vs. 291/496 (58.7%), p=0.981. A primary Gleason grade 4 was observed in 20.3% and 28.9% of Caucasians and African Americans respectively (p=0.890). Positive margins were noted in 162 (29.6%) Caucasians and 173 (36.7%) African Americans, p=0.016. Seminal vesicle invasion was noted in 46 (8.5%) Caucasians and 46 (10.0%) African Americans, p=0.420. Among intermediate risk patients, 92/378 (24.3%) of Caucasians were upgraded to primary Gleason 4 versus 79/329 (24.0%) of African Americans, p=0.919. Positive margins were observed in 36.2% of Caucasians and 40.4% of African Americans, p=0.527. Seminal vesicle invasion was observed in 12.0% Caucasians and 14.7% African Americans, p=0.290. CONCLUSIONS Using loose criteria for active surveillance, both Caucasians and African Americans had a similar rate of eligibility. We found that African American race, with exception of margin status in low risk patients, was not a risk factor for adverse pathological outcome at radical prostatectomy in low and intermediate risk active surveillance patients. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e141 Peer Review Report Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mihailo Popovic Detroit, MI More articles by this author Steven M. Lucas Detroit, MI More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...