Racial disparities in biochemical recurrence of prostate cancer

Background: The aim of this study was to determine the biochemical recurrence among Black and White American men with grade group 2-5 prostate cancer managed primarily by radical prostatectomy (RP). Methods: This was a single-institution, retrospective study evaluating biochemical recurrence by self-identified race. 163 patients who underwent RP at the University Hospitals Cleveland Medical Center between 2015-2021 were analyzed for racial differences in age at diagnosis, clinical stage, and preoperative serum prostate-specific antigen (PSA). Patients were followed for PSA recurrence (PSA >= 0.2 ng/ml). Multivariate analysis was used to determine clinical and pathologic variables that were significant in predicting biochemical recurrence after RP and to determine whether race was an independent predictor of biochemical recurrence-free survival (BCRFS). Results: Of 163 patients, 82 (50.3%) were Black Americans and 81 (49.7%) were White Americans with a median age of 62.7 ranging between 38.7 to 76.3 years. The grade-specific distribution of cancer 3+4 was 54.9% versus 65.4%; 4+3 was 25.6% versus 30.9%; 4+4 was 7.3% versus 2.5%; 4+5 was 12.2% versus 1.2% in Black American and White American men. Univariate analysis of BCRFS using Kaplan-Meier method demonstrated a significant difference among levels of Gleason score between Black Americans and White Americans (P = 0.041). Multivariable analysis after controlling the effects of age, Gleason score exhibited no significant difference of BCRFS comparing Black and White American men (P = 0.145). Specifically, the hazard of biochemical recurrence among Black Americans was 1.6 times (95% CI: 0.85-3.02) compared to White Americans (P = 0.145). Conclusion: Our study demonstrated a significant difference in BCRFS between Black and White American patients. Additional studies with larger sample size underlying this clinical disparity are warranted.