Login to Access Video or Poster Abstract: MP64-20
Sources of Funding: None

Introduction

Several studies suggest race-based health disparities in men with low-risk prostate cancer (PCa), with African-American males having poorer oncological outcomes. We sought to determine the predictors of pathological upgrading and upstaging in a cohort of black Jamaican males with low-risk PCa who underwent radical prostatectomy (RP) between 2000 and 2015._x000D_

Methods

We studied 141 men who met National Comprehensive Cancer Network criteria for low-risk PCa and underwent RP at the University Hospital of the West Indies, Kingston, Jamaica. All men had a minimum of a 12 core trans-rectal ultrasound-guided biopsy. Pre-operative clinical and final pathological data were obtained. Data were summarized as means and standard deviations or percentages as appropriate. Bivariate analyses such as independent samples t tests and chi square tables were conducted and logistic regression models were estimated to predict upgrading (> Gleason 6) and upstaging (≥ pT3)._x000D_ _x000D_

Results

Mean age was 59.5 ± 7.8 years with mean PSA of 6.6 ± 2 ng/ml. A total of 48.3% of men were upgraded and 30.8% were upstaged. Bivariate analyses indicated that PSA levels (p=0.008) and percentage of cancer found on biopsy (p=0.002) were associated with upgrading. Clinical T stage (p=0.020), number of positive cores found (p=0.024) and the percentage of cancer found on biopsy (p=0.004) were significantly associated with upstaging. The odds of upgrading increased with increased PSA levels (OR = 1.40; p= 0.021) or increased percentages of cancer found (OR = 8.27; p = 0.002). The odds of upstaging increased with increased percentages of cancer found (OR = 3.62; p = 0.039).

Conclusions

Jamaican males with low-risk PCa have high rates of poor pathological outcomes. Percentage cancer found on biopsy is significantly associated with upgrading and upstaging. These findings should be taken into consideration when discussing treatment options for these patients._x000D_

Funding

None