title: Significant change in predicted risk of biochemical recurrence after radical prostatectomy more common in black than in white men.
abstract: OBJECTIVE
  To examine by race how frequently the data after radical prostatectomy translates into a substantial change in prognosis. Many nomograms exist to predict the survival outcomes using the pretreatment clinical parameters and post-treatment pathologic parameters. Race might be an important factor affecting their predictive ability.
  
  
  METHODS
  Kattan nomograms were used to calculate the pretreatment and post-radical prostatectomy 5-year progression-free probability for each patient. The difference between the nomogram scores was used to divide the patients into 3 groups. A decrease in probability of >or=15 percentage points was classified as a significant increase in the probability of recurrence, an increase of >or=15 points was classified as a significant decrease in the probability of recurrence, and an absolute change of <15 points was considered no significant change.
  
  
  RESULTS
  The data from 1709 (132 black and 1577 white) men were analyzed. Among the black men, 26.5% had an increase in the probability of recurrence, 57.6% had no change, and 15.9% had a decrease in the probability of recurrence. Among the white men, 13.8% had an increase in the probability of recurrence, 64.5% had no change, and 21.7% had a decrease in the probability of recurrence. Black men were twice as likely to have a significant increase in the probability of recurrence postoperatively compared with white men after adjusting for preoperative prostate-specific antigen level, clinical stage, and biopsy Gleason sum (odds ratio 2.0, 95% confidence interval 1.3-3.1, P = .002).
  
  
  CONCLUSIONS
  These data could assist clinicians when counseling black men regarding their treatment options according to their preoperative risk profile.
authors: Department of Urology, Columbia University Medical Center, New York, NY 10032, USA. mal2117@columbia.edu
authors: Melissa A
authors: MA
authors: Laudano
authors: Ketan K
authors: KK
authors: Badani
authors: Tara R
authors: TR
authors: McCann
authors: Mark J
authors: MJ
authors: Mann
authors: Chad
authors: C
authors: Ritch
authors: Manisha
authors: M
authors: Desai
authors: Mitchell C
authors: MC
authors: Benson
authors: James M
authors: JM
authors: McKiernan
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D049451:Nomograms; D011379:Prognosis; D011468:Prostatectomy / Q000379:methods; D018570:Risk Assessment; D044465:White People