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Influence of African American race on the association between preoperative biopsy grade group and adverse histopathologic features of radical prostatectomy
Author(s) -
Aminsharifi Alireza,
Schulman Ariel,
Howard Lauren E.,
Tay Kae Jack,
Amling Christopher L.,
Aronson William J.,
Cooperberg Matthew R.,
Kane Christopher J.,
Terris Martha K.,
Freedland Stephen J.,
Polascik Thomas J.
Publication year - 2019
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.32168
Subject(s) - medicine , prostatectomy , odds ratio , biopsy , prostate cancer , pathological , logistic regression , urology , adverse effect , odds , surgery , cancer
Background The current study was performed to evaluate the influence of race on the association between biopsy grade group (GrGp) and the risk of detectable prostate‐specific antigen (PSA) and adverse histopathological outcomes after radical prostatectomy (RP). Methods Data regarding 4073 men (1344 African American men; 33%) who were treated with RP were categorized based on the 5‐tiered GrGp system. Logistic regression was used to test the association between biopsy GrGp and PSA nadir (<0.1 ng/mL) after RP as well as adverse pathological features among all patients and stratified by race. Results Those patients with a higher biopsy GrGp were found to have lower odds of achieving a PSA nadir <0.1 ng/mL after RP on unadjusted and multivariable analysis (both P < .001). On unadjusted and multivariable analysis, higher GrGp was associated with increased odds of each of the adverse pathological features, namely, GrGp ≥3, extraprostatic extension, seminal vesicle invasion, positive surgical resection margin, and positive lymph nodes (all P < .001). Race had no significant interaction with biopsy GrGp in the prediction of PSA nadir after RP ( P = .91) or any adverse pathological features (all P > .06) except positive lymph nodes. When the models were stratified by race, the associations between preoperative biopsy GrGp and having a PSA nadir <0.1 ng/mL, high‐grade final pathology, or other adverse histopathologic features were similar in both races except as noted for positive lymph nodes. Conclusions Higher preoperative biopsy GrGp is associated with increased odds of adverse histopathological findings as well as lower odds of a PSA nadir <0.1 ng/mL after RP. These associations are largely independent of race, suggesting that GrGp is an accurate tool for risk stratification in both black and white men.