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2008 Annual Meeting Abstracts
In Patients Eligible for Active Surveillance Treated with Radical Prostatectomy, Does Race Impact Postoperative Outcomes?
Matthew J. Resnick1, Daniel Canter1, Benjamin M. Brucker1, Thomas Guzzo2, Meredith R. Bergey*1, Seema Sonnad*1, Alan J. Wein1, S. Bruce Malkowicz1
1University of Pennsylvania School of Medicine, Philadelphia, PA;2Johns Hopkins School of Medicine, Baltimore, MD
Introduction:
Active surveillance has become a reasonable option for patients with low grade, low stage tumors. While early data suggests that there is little risk in delaying definitive treatment, there is little data to reconcile racial disparities surrounding prostate cancer outcomes in candidates for active surveillance.
Methods:
We reviewed our database of 2407 patients who underwent radical prostatectomy and isolated 648 White and 91 African-American patients who, preoperatively, fulfilled eligibility criteria for active surveillance. We studied pre- and postoperative parameters to discern any racial differences in this group of patients.
Results:
In patients eligible for active surveillance, all-cause mortality was found to be 4.9% and 7.7% in Whites and African-Americans respectively (p=0.271) and the risk of biochemical failure determined to be 5.9% and 5.5% (0.888). White and African-American patients manifested no significant differences in surrogate markers of disease control including risk of extraprostatic extension, risk of seminal vesicle invasion, the risk of positive surgical margins, or tumor volume. Upgrading at pathology was common, occurring in 27.5% of patients eligible for active surveillance, however, there was no significant difference in the risk of upgrading between Whites and African-Americans.
Conclusions:
In patients eligible for active surveillance who undergo radical prostatectomy, there are no significant differences in either surrogate measures of disease control, risk of upgrading, estimated tumor volume, overall, or recurrence-free survival between Whites and African-Americans. Taken together, these data suggest that there is no need to modify inclusion criteria for African-American patients enrolling in active surveillance protocols.
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