Population-based study of pelvic lymph node positivity in clinically localized prostate cancer: A study comparing African Americans and whites

Objectives. To evaluate the correlation between race and lymph node metasta sis for prostate cancer by analyzing which preoperative parameters may pred ict lymph node status in both races. Methods. We analyzed a group of patients (552 American white men [AWM] and 423 African-American men [AAM]) who underwent radical prostatectomy plus mo dified pelvic lymphadenectomy between January 1991 and June 1997. Patients who received neoadjuvant radiation or hormone therapy were excluded. Univar iate and multivariate analyses were performed to determine the influence of race on lymph node positivity, as well as to correlate the preoperative pa rameters (serum prostate-specific antigen [PSA], biopsy Gleason score, and clinical stage) with lymph node metastasis for each race separately. Results, The AAM presented with significantly higher preoperative Gleason s cores and PSA levels than AWM. However, comparing lymph node status by race , the difference of positivity (41 AWM [7.4%] and 22 AAM [5.2%]) was not st atistically significant (P = 0.16). The percentage of positive nodes was si milar in both races for each subset of PSA, Gleason score, and clinical sta ge. Despite the statistical significance of the three preoperative paramete rs in univariate analysis, in multivariate analysis only PSA and Gleason sc ore were independent predictors of positive lymph nodes. Conclusions. There is no influence of race on lymph node metastasis, despit e AAM presenting with higher preoperative Gleason scores and PSA levels. In multivariate analysis, preoperative Gleason score and PSA were independent factors for positive nodes regardless of race. UROLOGY 53: 187-191, 1999. (C) 1999, Elsevier Science Inc. All rights reserved.