Influence of African American race on the association between preoperative biopsy grade group and adverse histopathologic features of radical prostatectomy

Abstract

BACKGROUND:The current study was performed to evaluate the influence of race on the association between biopsy grade group (GrGp) and the risk of detectable prostate-specific antigen (PSA) and adverse histopathological outcomes after radical prostatectomy (RP). METHODS: Data regarding 4073 men (1344 African American men; 33%) who were treated with RP were categorized based on the 5-tiered GrGp system. Logistic regression was used to test the association between biopsy GrGp and PSA nadir (<0.1 ng/mL) after RP as well as adverse pathological features among all patients and stratified by race. RESULTS: Those patients with a higher biopsy GrGp were found to have lower odds of achieving a PSA nadir <0.1 ng/mL after RP on unadjusted and multivariable analysis (both P < .001). On unadjusted and multivariable analysis, higher GrGp was associated with increased odds of each of the adverse pathological features, namely, GrGp ≥3, extraprostatic extension, seminal vesicle invasion, positive surgical resection margin, and positive lymph nodes (all P < .001). Race had no significant interaction with biopsy GrGp in the prediction of PSA nadir after RP (P = .91) or any adverse pathological features (all P > .06) except positive lymph nodes. When the models were stratified by race, the associations between preoperative biopsy GrGp and having a PSA nadir <0.1 ng/mL, high-grade final pathology, or other adverse histopathologic features were similar in both races except as noted for positive lymph nodes. CONCLUSIONS: Higher preoperative biopsy GrGp is associated with increased odds of adverse histopathological findings as well as lower odds of a PSA nadir <0.1 ng/mL after RP. These associations are largely independent of race, suggesting that GrGp is an accurate tool for risk stratification in both black and white men. Cancer 2019;125:3025-3032.

Evaluating Incidence, Location, and Predictors of Positive Surgical Margin Among Chinese Men Undergoing Robot-Assisted Radical Prostatectomy

“…Some study found that race was largely independent of adverse pathological features including extracapsular extension, seminal vesical invasion, and PSM after radical prostatectomy. 24 , 25 The underlying causes of higher PSM rates among Chinese population, including tumor biology, technical aspect, surgeon’s experience, and the reporting pathologist, need to be explored.…”

Diagnostic performance of a nomogram incorporating cribriform morphology for the prediction of adverse pathology in prostate cancer at radical prostatectomy

“…In addition, a higher GG was found to be associated with an increased risk of adverse pathology in PCa compared with RP pathological results. Aminsharifi et al (27), showed that a higher preoperative biopsy GG is linked to a higher risk of adverse histopathological findings at the time of RP. Hence, for a patient with a high biopsy GG and positive cribriform morphology on biopsy, a careful evaluation should be conducted to ensure suitable treatment strategies are followed.…”