Differences in the aggressiveness of prostate cancer among Korean, Caucasian, and African American men: A retrospective cohort study of radical prostatectomy.
OBJECTIVE
We aimed to compare the pathologic aggressiveness of clinically localized prostate cancer (PCa) treated by radical prostatectomy in Korean and Western (Caucasian and African American [AA]) men by analyzing data from representative hospitals in the capitals of Korea (Seoul) and the United States (Washington, DC).


METHODS
We performed a retrospective cohort study of 1,939 patients who underwent radical prostatectomy for clinically localized PCa in the Asan Medical Center and Washington Hospital Center. After adjusting for confounding clinical variables, we used multivariate logistic regression analysis to assess differences in the aggressiveness of PCa.


RESULTS
We analyzed 1,152 Korean, 473 Caucasian, and 314 AA patients. There were significant differences between Korean and Western patients in terms of age at surgery, preoperative levels of prostate-specific antigen, and clinical stage (P<0.001). Overall, high-grade PCa (Gleason score≥8) was more common in Korean (19.4%) than in AA (6.1%) or Caucasian (5.5%) patients (P<0.001). The incidence of advanced-stage PCa (pT3 or higher) was higher in Korean (34.8%) than in AA (18.2%) or Caucasian (13.3%) patients (P<0.001). After adjusting for age, prostate-specific antigen, prostate volume, and clinical stage, multivariate logistic regression analysis showed that Korean men had a high risk of high-grade PCa (Korean vs. Caucasian, odds ratio [OR] = 3.48, P<0.001; Korean vs. AA, OR=3.14, P<0.001) or advanced-stage PCa (Korean vs. Caucasian, OR=2.40, P<0.001; Korean vs. AA, OR = 1.59, P = 0.009) than Western men.


CONCLUSIONS
There are differences in PCa aggressiveness between Korean and Western men. The incidence of high-grade or advanced-stage PCa is higher in Korean men.
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
In Gab
IG
Jeong
Department of Urology, Georgetown University School of Medicine, Washington, DC.
Daoud
D
Dajani
Department of Urology, Georgetown University School of Medicine, Washington, DC.
Mohan
M
Verghese
Department of Urology, Georgetown University School of Medicine, Washington, DC.
Jonathan
J
Hwang
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Yong Mee
YM
Cho
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Jun Hyuk
JH
Hong
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Electronic address: cskim@amc.seoul.kr.
Choung-Soo
CS
Kim
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Hanjong
H
Ahn
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Pathology and Genomic Medicine, The Methodist Hospital and Weil Medical College of Cornell University, Houston, TX.
Jae Y
JY
Ro
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian / Q000706:statistics & numerical data*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
D017430:Prostate-Specific Antigen
Neoplasm grading; Neoplasm staging; Prostatic neoplasm