Characteristics of prostate cancers in French men of African and Caribbeanorigin.

Objectives : To evaluate the clinical, laboratory and histological characte ristics of prostate cancer nt the time of diagnosis and after radical treat ment in various ethnically different patient,groups Patients and Methods : Prostatic biopsies were performed in 466 consecutive patients because of an abnormal digital rectal examination and/or isolated elevation of PSA (greater than 3 ng/ml). In this series, 40 patients were Black and 426 were Caucasian. The other aspect of the study concerns 320 pa tients undergoing radical prostatectomy for stage T1 T2 prostatic tumour (2 5 Black, 295 Caucasian). In the biopsied group, rue analysed mean age, mean PSA, mean cancer length on biopsies and mean Gleason score. In the operate d group, we studied preoperative characteristics, histological stage, resec tion margin status, laboratory progression (PSA greater than 0.05 ng/ml) an d time ro progression. Results :At the time of diagnosis, the mean age was 61.4 years (48-73) for Blacks and 65.2 years (42-87) for Caucasians (p < 0.05). The median Gleason score was 7 in the two groups. The PSA was 13.4 (1.7-105) ng/ml versus 14. 4 (0.4-600) ng/ml, respectively. The mean percentage of invaded tissue on b iopsies tt as 24% versus 18.8% and the mean percentage of positive biopsies wets 53% verses 39%, respectively. In the operated group capsular effracti on rates were 39% in Blacks and 48.1% in Caucasians. Positive resection mar gin rates were 21.7% versus 36.6%, respectively The laboratory progression rare with a mean follow-up of 33 months (6-126) was identical in the 2 grou ps (42.1% versus 41.1%), but the time to progression was shorter for Blacks (9 months versus 12.3 months). Conclusions : ln this patient series, Black patients had the same laborator y profile ns Caucasian patients at the time of diagnosis. However they were younger at the time of discovery of the disease, had more positive biopsie s and more tumour-invaded tissue on biopsies, and Black patients undergoing radical prostatectomy developed laboratory recurrence more rapidly.