TY - JOUR

T1 - Significant Change in Predicted Risk of Biochemical Recurrence After Radical Prostatectomy More Common in Black Than in White Men

AU - Laudano, Melissa A.

AU - Badani, Ketan K.

AU - McCann, Tara R.

AU - Mann, Mark J.

AU - Ritch, Chad

AU - Desai, Manisha

AU - Benson, Mitchell C.

AU - McKiernan, James M.

PY - 2009/9

Y1 - 2009/9

N2 - Objectives: To examine by race how frequently the data after radical prostatectomy translates into a substantial change in prognosis. Many nomograms exist to predict the survival outcomes using the pretreatment clinical parameters and post-treatment pathologic parameters. Race might be an important factor affecting their predictive ability. Methods: Kattan nomograms were used to calculate the pretreatment and post-radical prostatectomy 5-year progression-free probability for each patient. The difference between the nomogram scores was used to divide the patients into 3 groups. A decrease in probability of ≥15 percentage points was classified as a significant increase in the probability of recurrence, an increase of ≥15 points was classified as a significant decrease in the probability of recurrence, and an absolute change of <15 points was considered no significant change. Results: The data from 1709 (132 black and 1577 white) men were analyzed. Among the black men, 26.5% had an increase in the probability of recurrence, 57.6% had no change, and 15.9% had a decrease in the probability of recurrence. Among the white men, 13.8% had an increase in the probability of recurrence, 64.5% had no change, and 21.7% had a decrease in the probability of recurrence. Black men were twice as likely to have a significant increase in the probability of recurrence postoperatively compared with white men after adjusting for preoperative prostate-specific antigen level, clinical stage, and biopsy Gleason sum (odds ratio 2.0, 95% confidence interval 1.3-3.1, P = .002). Conclusions: These data could assist clinicians when counseling black men regarding their treatment options according to their preoperative risk profile.

AB - Objectives: To examine by race how frequently the data after radical prostatectomy translates into a substantial change in prognosis. Many nomograms exist to predict the survival outcomes using the pretreatment clinical parameters and post-treatment pathologic parameters. Race might be an important factor affecting their predictive ability. Methods: Kattan nomograms were used to calculate the pretreatment and post-radical prostatectomy 5-year progression-free probability for each patient. The difference between the nomogram scores was used to divide the patients into 3 groups. A decrease in probability of ≥15 percentage points was classified as a significant increase in the probability of recurrence, an increase of ≥15 points was classified as a significant decrease in the probability of recurrence, and an absolute change of <15 points was considered no significant change. Results: The data from 1709 (132 black and 1577 white) men were analyzed. Among the black men, 26.5% had an increase in the probability of recurrence, 57.6% had no change, and 15.9% had a decrease in the probability of recurrence. Among the white men, 13.8% had an increase in the probability of recurrence, 64.5% had no change, and 21.7% had a decrease in the probability of recurrence. Black men were twice as likely to have a significant increase in the probability of recurrence postoperatively compared with white men after adjusting for preoperative prostate-specific antigen level, clinical stage, and biopsy Gleason sum (odds ratio 2.0, 95% confidence interval 1.3-3.1, P = .002). Conclusions: These data could assist clinicians when counseling black men regarding their treatment options according to their preoperative risk profile.

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U2 - 10.1016/j.urology.2008.10.075

DO - 10.1016/j.urology.2008.10.075

M3 - Article

C2 - 19589568

AN - SCOPUS:69249210986

VL - 74

SP - 660

EP - 664

JO - Urology

JF - Urology

SN - 0090-4295

IS - 3

ER -