Prostate specific antigen progression after radical prostatectomy in African-American men versus white men

BACKGROUND. It is well established that African-American men (AAM) have a worse mortality from prostate carcinoma (PC) than White men (WM). Outcome data for men treated with radical prostatectomy for clinically localized PC demonstrate more advanced tumors and higher biochemical recurrence rates among AAM compared with WM. The objective of the current study was to characterize the pattern of prostate specific antigen (PSA) progression by race in patients experiencing disease recurrence after undergoing radical prostatectomy. Racial differences in the pattern of rising PSA would warrant different intervention strategies for reducing the disproportionality in survival outcomes between the two racial groups. METHODS. Between 1991-1996, 1080 consecutive men underwent radical prostatectomy for clinically localized PC at Wayne State University-affiliated Harper Hospital. Two hundred forty-one patients developed a biochemical recurrence on or before January, 1, 1999. The median follow-up was 39 months. Longitudinal PSA profiles of 77 men who met the study inclusion criteria were analyzed. Average relative velocities of PSA were compared between AAM and WM. Linear mixed effects regression was used to test the hypothesis that, after adjusting for age, preoperative PSA, stage and grade of disease, PSA levels increase at a faster rate in AAM compared with WM. RESULTS. The mean average relative velocity for AAM and WM experiencing a disease recurrence was 0.25 ng/mL and 0.11 ng/mL per month, respectively (P = 0.21). The relative rate of PSA increase in patients who developed a disease recurrence after radical prostatectomy was 18.9% per month for AAM and 16.3% per month for WM (P = 0.73). CONCLUSIONS. AAM and WM appear to have similar rates of PSA progression after undergoing radical prostatectomy. (C) 2002 American Cancer Society.