Objectives. To determine whether race is an independent predictor of positi
ve surgical margins in patients who undergo radical prostatectomy.
Methods, Radical prostatectomies were performed on 750 patients at five Vet
erans Affairs hospitals: Shreveport, Louisiana (n = 451), Houston, Texas (n
= 92), Jackson, Mississippi (n = 83), New Orleans, Louisiana (n = 69), and
Little Rock, Arkansas (n = 55). All men who did not receive neoadjuvant ho
rmonal therapy and for whom complete follow-up data were available were inc
luded in the analysis (of 607, 260 were African-American and 347 were white
). Multiple logistic regression analysis was used to determine the signific
ance of race as an independent predictor of surgical margin status after ra
dical prostatectomy for clinically localized prostate cancer,
Results. After controlling for clinical stage, Gleason grade, and preoperat
ive prostate-specific antigen (PSA), multivariable logistic regression anal
ysis revealed that race was not an independent predictor of positive surgic
al margins (P = 0.9). Of the variables evaluated, both preoperative PSA (P
= 0.0005) and biopsy Gleason grade (P = 0.047) were significant predictors
of an increased risk of a positive surgical margin.
Conclusions. Positive surgical margins are a widely accepted surrogate mark
er of increased biologic potential in patients with prostate cancer. In our
study population, race was not an independent predictor of surgical margin
status. Coupled with observations that survival is not related to race, th
is finding suggests that the biology of prostate cancer in African-American
and white men is similar and that observed racial differences more likely
are due to ethnic factors that influence tumorigenicity. UROLOGY 54: 869-87
4, 1999. (C) 1999, Elsevier Science Inc.