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

Alireza Aminsharifi, Ariel Schulman, Lauren E. Howard, Kae Jack Tay, Christopher L. Amling, William J. Aronson, Matthew R. Cooperberg, Christopher J. Kane, Martha Kennedy Terris, Stephen J. Freedland, Thomas J. Polascik

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)3025-3032
Number of pages8
JournalCancer
Volume125
Issue number17
DOIs
StatePublished - Jan 1 2019

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Prostate-Specific Antigen
Prostatectomy
African Americans
Biopsy
Lymph Nodes
Logistic Models
Pathology

Keywords

  • African American
  • prostate cancer
  • prostate cancer grade group
  • race
  • radical prostatectomy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Aminsharifi, A., Schulman, A., Howard, L. E., Tay, K. J., Amling, C. L., Aronson, W. J., ... Polascik, T. J. (2019). Influence of African American race on the association between preoperative biopsy grade group and adverse histopathologic features of radical prostatectomy. Cancer, 125(17), 3025-3032. https://doi.org/10.1002/cncr.32168

Influence of African American race on the association between preoperative biopsy grade group and adverse histopathologic features of radical prostatectomy. / Aminsharifi, Alireza; Schulman, Ariel; Howard, Lauren E.; Tay, Kae Jack; Amling, Christopher L.; Aronson, William J.; Cooperberg, Matthew R.; Kane, Christopher J.; Terris, Martha Kennedy; Freedland, Stephen J.; Polascik, Thomas J.

In: Cancer, Vol. 125, No. 17, 01.01.2019, p. 3025-3032.

Research output: Contribution to journalArticle

Aminsharifi, A, Schulman, A, Howard, LE, Tay, KJ, Amling, CL, Aronson, WJ, Cooperberg, MR, Kane, CJ, Terris, MK, Freedland, SJ & Polascik, TJ 2019, 'Influence of African American race on the association between preoperative biopsy grade group and adverse histopathologic features of radical prostatectomy', Cancer, vol. 125, no. 17, pp. 3025-3032. https://doi.org/10.1002/cncr.32168
Aminsharifi, Alireza ; Schulman, Ariel ; Howard, Lauren E. ; Tay, Kae Jack ; Amling, Christopher L. ; Aronson, William J. ; Cooperberg, Matthew R. ; Kane, Christopher J. ; Terris, Martha Kennedy ; Freedland, Stephen J. ; Polascik, Thomas J. / Influence of African American race on the association between preoperative biopsy grade group and adverse histopathologic features of radical prostatectomy. In: Cancer. 2019 ; Vol. 125, No. 17. pp. 3025-3032.
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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.",
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T1 - Influence of African American race on the association between preoperative biopsy grade group and adverse histopathologic features of radical prostatectomy

AU - Aminsharifi, Alireza

AU - Schulman, Ariel

AU - Howard, Lauren E.

AU - Tay, Kae Jack

AU - Amling, Christopher L.

AU - Aronson, William J.

AU - Cooperberg, Matthew R.

AU - Kane, Christopher J.

AU - Terris, Martha Kennedy

AU - Freedland, Stephen J.

AU - Polascik, Thomas J.

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N2 - 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.

AB - 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.

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KW - radical prostatectomy

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