Racial Disparities in Prostate Ca Recurrence

SAN FRANCISCO—Black men are more likely than white men to have a prostate cancer recurrence after radical prostatectomy, Hadley M. Wood, MD, reported at the 2006 Prostate Cancer Symposium (abstract 138). Dr. Wood is a resident at the Glickman Urological Institute of the Cleveland Clinic Foundation. This prospective study assessed biochemical failure rates in 2,910 men of both races during two time periods: the "early PSA period" (1987-1997) and the "later PSA period" (1998-2004). The men were followed for at least 12 months after surgery, with biochemical failure defined as PSA more than 0.2 ng/mL. Both groups were more likely to have organ-confined disease during the later PSA period; rates increased from 54% in the early period to 76% in the later period for black men (P = .0001) and from 50% to 71% for white men (P < .0001). Progression-free survival (PFS) at 5 years increased in both groups between the two periods, from 67% to 71% for blacks and from 78% to 82% for whites. The difference in PFS between the races, however, remained constant at 11% during both periods. Dr. Wood said this difference occurred even though black men were more likely to have organ-confined disease, and both groups had similar Gleason scores, clinical T stage, and initial PSA level.