Multivariate analysis of race and adverse pathologic findings after radical prostatectomy

Adverse pathologic features that predict disease recurrence after radical prostatectomy (RP) include positive surgical margins, non-organ-confined disease, and seminal vesicle invasion. Given that black men have a higher incidence of, and mortality from, prostate cancer compared with white men, we sought to determine whether race was an independent predictor of adverse pathologic findings among men who underwent RP at an equal access health care center. Results from previous studies evaluating whether race predicts positive surgical margins have been conflicting. No prior studies have evaluated whether race is an independent predictor of non-organ-confined disease or seminal vesicle invasion.

A retrospective survey of 274 patients (126 black, 148 white) who underwent RP at the West Los Angeles Veterans Affairs Medical Center between 1991 and 1999 was undertaken. Multivariate analysis was used to determine the preoperative clinical variables that were most significant in predicting positive surgical margins, non-organ-confined disease, and seminal vesicle invasion. The preoperative variables analyzed were race, age, serum prostate-specific antigen, clinical stage, and biopsy Gleason score.

No differences in the incidence of positive surgical margins, non-organ-confined disease, or seminal vesicle invasion were found between black and white men undergoing RP. After controlling for the preoperative variables of age, serum prostate-specific antigen level, clinical stage, and biopsy Gleason score, race was not an independent predictor of positive surgical margins, non-organ-confined disease, or seminal vesicle invasion.

This is the first study to show that black race was not an independent predictor of non-organ-confined disease or seminal vesicle invasion among patients undergoing RP. Furthermore, race was not an independent predictor of positive surgical margins.