Disease recurrence in black and white men undergoing radical prostatectomyfor clinical stage T1-T2 prostate cancer

Purpose: The reported incidence and mortality of prostate cancer are higher among black than white men. Reasons for the disproportionate racial incide nce of this disease are not known but most surveys suggest that increased m ortality among black men is due to more advanced tumor stage at diagnosis. To determine if racial differences exist in men with similar stage disease we compared disease recurrence in black and white men who underwent radical prostatectomy for clinical stage T1-T2 prostate cancer. Materials and Methods: We reviewed the records of all 257 white and 218 bla ck men undergoing radical prostatectomy for clinical stage T1-T2 prostate c ancer at the Louisiana State University Medical Center-Shreveport and the O verton-Brooks Veterans Affairs Medical Center between January 1990 and Nove mber 1998. Age, race, serum prostate specific antigen (PSA), ultrasound mea sured prostate volume, PSA density (PSA divided by prostate volume), histol ogical features of the prostate biopsy, clinical stage, pathological stage, histological features of the radical prostatectomy specimen and disease re currence were reviewed. Results: Black men had significantly higher mean serum PSA and PSA density than white men (2-sided p = 0.005 and 0.03, respectively). There were no st atistically significant differences by race in terms of patient age, prosta te volume,clinical stage, biopsy Gleason score, pathological stage, positiv e pelvic lymph nodes, positive surgical margins or PSA recurrence rates. Conclusions: Black men with clinical stage T1-T2 prostate cancer who underw ent radical prostatectomy had significantly higher serum PSA and PSA densit y than similarly treated white men. However, race appears to have no indepe ndent impact on pathological findings or disease recurrence in men with cli nically localized prostate cancer treated with radical prostatectomy when t he effects of differences in serum PSA are controlled.