Multivariate analysis of race and adverse pathologic findings after radical prostatectomy

Objectives. Adverse pathologic features that predict disease recurrence aft er radical prostatectomy (RP) include positive surgical margins, non-organ- confined disease, and seminal vesicle invasion. Given that black men have a higher incidence of, and mortality from, prostate cancer compared with whi te men, we sought to determine whether race was an independent predictor of adverse pathologic findings among men who underwent RP at an equal access health care center. Results from previous studies evaluating whether race p redicts positive surgical margins have been conflicting. No prior studies h ave evaluated whether race is an independent predictor of non-organ-confine d disease or seminal vesicle invasion. Methods, A retrospective survey of 274 patients (126 black, 148 white) who underwent RP at the West Los Angeles Veterans Affairs Medical Center betwee n 1991 and 1999 was undertaken. Multivariate analysis was used to determine the preoperative clinical variables that were most significant in predicti ng positive surgical margins, non-organ-confined disease, and seminal vesic le invasion. The preoperative variables analyzed were race, age, serum pros tate-specific antigen, clinical stage, and biopsy Gleason score. Results. No differences in the incidence of positive surgical margins, non- organ-confined disease, or seminal vesicle invasion were found between blac k and white men undergoing RP. After controlling for the preoperative varia bles of age, serum prostate-specific antigen level, clinical stage, and bio psy Gleason score, race was not an independent predictor of positive surgic al margins, non-organ-confined disease, or seminal vesicle invasion. Conclusions. This is the first study to show that black race was not an ind ependent predictor of non-organ-confined disease or seminal vesicle invasio n among patients undergoing RP. Furthermore, race was not an independent pr edictor of positive surgical margins. UROLOGY 56: 807-811, 2000. (C) 2000, Elsevier Science Inc.