Disease-free survival difference between African Americans and whites after radical prostatectomy for local prostate cancer: a multivariable analysis.
OBJECTIVE
Age-adjusted mortality rates (per 100,000) for men with prostate cancer from 1991 through 1997 reported by the Surveillance, Epidemiology, and End Results national registry have consistently demonstrated that African-American men (AAM) have twice the death rate of white men (WM). However, there has been considerable controversy as to how this relates to progression-free survival among these men. In an attempt to address this controversy of localized prostate cancer, we report on a multivariable analysis of survival data of a large number of AAM and WM who underwent radical prostatectomy.


METHODS
The study cohort was composed of 791 men whose only prostate cancer treatment was radical prostatectomy performed between July 1990 and December 1999. The variables analyzed were age, preoperative prostate-specific antigen level, pathologic grade and stage, and race/ethnicity. Pathologic examination of all specimens was performed in a uniform manner according to an established protocol. Multivariable analysis based on Cox's proportional hazards regression model was performed to assess whether a significant difference in progression-free survival time between AAM and WM persisted after controlling for the main effects of other prognostic factors.


RESULTS
The study cohort consisted of 229 AAM and 562 WM. Our results indicated that all variables, except age, had highly significant effects on progression-free survival, even in the presence of other predictors.


CONCLUSIONS
The effects of age, preoperative serum prostate-specific antigen level, and pathologic grade and stage did not account for the racial disparity in progression-free survival among men diagnosed with clinically localized prostate cancer and treated with radical prostatectomy.
Powell
Isaac J
IJ
Department of Urology, Wayne State University School of Medicine, Detroit, Michigan 48201, USA.
Dey
Jyotirmoy
J
Dudley
Amanda
A
Pontes
J Edson
JE
Cher
Michael L
ML
Sakr
Wael
W
Grignon
David J
DJ
Wood
David P
DP
D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D015331:Cohort Studies; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000401:mortality*; D011471:Prostatic Neoplasms / Q000208:ethnology / Q000401:mortality* / Q000601:surgery; D015203:Reproducibility of Results; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
D017430:Prostate-Specific Antigen