Racial influence on biochemical disease-free survival in men treated with external-beam radiotherapy for localized prostate cancer.
BACKGROUND
We retrospectively analyzed the clinical characteristics and outcomes of various racial and ethnic groups who underwent radiotherapy alone for localized or locally advanced prostate cancer.


METHODS
From April 1987 to January 1998, 964 patients underwent full-dose, external-beam radiotherapy alone for localized or locally advanced prostate cancer and were included in the study. The patients' medical records were reviewed for pertinent information.


RESULTS
Of the 964 patients, 810 were non-Hispanic white, 86 were African-American, 54 were Hispanic, and 14 were Asian. The most significant difference between groups was in the proportion of patients who presented with initial PSA levels > 20 ng/ml. More than 20% of men in all minority groups presented with a serum PSA > 20 ng/ml, compared to only 11% of whites (p = 0.0012). Similarly, 14% of minorities presented with Gleason scores > or = 8 compared to only 11% of whites (p = 0.0265). Hispanic and Asian patients exhibited a higher incidence of Gleason score > or = 8 prostate cancer. When comparing the time intervals of 1995-1998 vs. 1987-1994, the number of men presenting for EBRT with PSA levels < 10 ng/ml increased to 74% from 57% for Caucasians (p < 0,001), 71% from 40% for African Americans (p = 0.012), 67% from 49% for Hispanics (p = 0.1 18), and no change (50%) for Asians.


CONCLUSIONS
The number of African-American patients presenting with favorable characteristics (PSA < 10 ng/ml) is increasing. These findings suggest that the message of screening and early detection may be reaching the African-American community. Continued diligence in screening and early detection may improve prostate cancer outcome for other minority populations.
Rosser
Charles J
CJ
Department of Urology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA.
Kuban
Deborah A
DA
Lee
Sang-Joon
SJ
Levy
Lawrence B
LB
Pettaway
Curtis
C
Kamat
Ashish M
AM
Chichakli
Ramsey
R
Lee
Andrew
A
Cheung
Rex M
RM
Sanchez-Ortiz
Ricardo
R
Pisters
Louis L
LL
D001741:Black or African American; D000368:Aged; D001213:Asian; D018572:Disease-Free Survival; D006630:Hispanic or Latino; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000208:ethnology* / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy
D017430:Prostate-Specific Antigen