title: Pathological outcomes and agressiveness of low-risk prostate cancer in Northern African men.
abstract: BACKGROUND
  Northern African (NAf) men show a high incidence of advanced prostate cancer (PCa) at diagnosis. Several studies suggested the existence of ethnic differences in the PCa aggressiveness and this has led to some concerns related to the inclusion of some ethnic groups into active surveillance protocols.
  
  
  OBJECTIVE
  To evaluate pathological outcomes and aggressiveness of low risk PCa treated by radical prostatectomy in a NAf ethnic group.
  
  
  METHODS
  Data of 147 NAfs, who underwent radical prostatectomy for low risk PCa diagnosed via a 12-core biopsy in 2 academic centers between 2011 and 2015, were reviewed retrospectively to assess rates of worse pathological outcomes defined as: Gleason score upgrade to at least 3+4, upstage to pT3a or higher or pN1, and positive surgical margins.
  
  
  RESULTS
  Overall significant upstage and/or upgrade occurred in 20.2% and positive surgical margins occured in18.3%. In multivariate logistic regression analysis, independent variables that predicted for upstage and/or upgrade or positive surgical margins in the entire cohort were: NCCN risk group (low risk>very low risk), advanced age>60 years, PSA>6ng/ml, PSA density≥0.15, more than 2 positive cores in biopsy, more than 50% cancer involvement in positive cores, clinical stage (T2a>T1c) and UCSF-CAPRA-S score>3.
  
  
  CONCLUSIONS
  Our study found that, at least pathologically, NAf men do not have more aggressive disease than Caucasians and African Americans in both low and very low risk PCa. Thus, we think that active surveillance is a suitable approach for selected patients since there is no definitive data that show a more aggressive natural history of PCa in NAf men.
authors.affiliation: Department of Urology, Faculty of Medicine and Pharmacy, University Sidi Mohammed Ben Abdellah, Fez, Marruecos; Department of Urology, Universitary Military Hospital Moulay Ismail, Mequinez, Marruecos; Center of Doctoral Studies (PhD) of Life and Heath Sciences, Faculty of Medicine and Pharmacy, University Mohammed V, Rabat, Marruecos. Electronic address: ammani-1@hotmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Ammani
authors.affiliation: Department of Urology, Universitary Military Hospital Mohammed V, Rabat, Marruecos.
authors.forename: A
authors.initials: A
authors.lastname: Janane
authors.affiliation: Department of Urology, Universitary Military Hospital Moulay Ismail, Mequinez, Marruecos.
authors.forename: B
authors.initials: B
authors.lastname: Bouzide
authors.affiliation: Department of Urology, Universitary Military Hospital Moulay Ismail, Mequinez, Marruecos.
authors.forename: Y
authors.initials: Y
authors.lastname: Dehayni
authors.affiliation: Department of Urology, Universitary Military Hospital Moulay Ismail, Mequinez, Marruecos.
authors.forename: M
authors.initials: M
authors.lastname: Lezrek
authors.affiliation: Department of Urology, Universitary Military Hospital Mohammed V, Rabat, Marruecos.
authors.forename: M
authors.initials: M
authors.lastname: Ghadouane
authors.affiliation: Department of Urology, Universitary Military Hospital Mohammed V, Rabat, Marruecos.
authors.forename: A
authors.initials: A
authors.lastname: Ameur
authors.affiliation: Department of Urology, Universitary Military Hospital Mohammed V, Rabat, Marruecos.
authors.forename: M
authors.initials: M
authors.lastname: Abbar
authors.affiliation: Department of Urology, Faculty of Medicine and Pharmacy, University Sidi Mohammed Ben Abdellah, Fez, Marruecos; Department of Urology, Universitary Military Hospital Moulay Ismail, Mequinez, Marruecos.
authors.forename: A
authors.initials: A
authors.lastname: Qarro
authors.affiliation: Department of Urology, Faculty of Medicine and Pharmacy, University Sidi Mohammed Ben Abdellah, Fez, Marruecos; Department of Urology, Universitary Military Hospital Moulay Ismail, Mequinez, Marruecos.
authors.forename: M
authors.initials: M
authors.lastname: Alami
mesh_terms: D000352:Africa, Northern; D000368:Aged; D044383:Black People; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D001741:Black or African American
keywords: Active surveillance; Actualización; Bajo riesgo; Cáncer de próstata; Eclipse; Low risk; Norte de África; Northern Africa; Prostate cancer; Upgrade; Upstage; Vigilancia activa