San Diego, CA USA (UroToday.com) It is widely known that African American (AA) men have an increased risk of high-grade prostate cancer. One of the proposed explanations for the disproportionate incidence of high-risk prostate cancer in AA is due to a greater amount of anterior prostate lesions (APLs) in this population.
Investigators from the National Cancer Institute sought to evaluate APLs using multiparametric MRI (mpMRI) in matched cohort of AA and White/Other (W/O) men groups.
A total of 195 AA and 194 W/O men were evaluated with MRI-TRUS fusion biopsies. AA were found to have a higher incidence of prostate cancer compared to W/O men (64% vs, 50%, p = 0.007). However, there were no differences in the rate of APLs between AA and W/O groups (47.7% vs. 51.5%, respectively). The Gleason score of APLs in AA men was in concordance with whole mount pathology from the final specimen 90% of the time compared to only 53% for W/O men. Overall, men with higher PSA values and smaller volume prostates were at an increased risk of having positive APLs (both p <0.007).
As APLs represent a challenge to obtain through standard biopsies, the authors made reference to work from Jonhs Hopkins published in Urology, concluding that AA men tend to have higher incidence of APLs. The authors would like to see other high volume centers conduct similar research in the use of more sophisticated biopsy techniques, but they suspect other groups will see higher incidences of APLs in AA men. In addition, the use of advanced biopsy platforms, such as MRI-TRUS fusion biopsies, will help further clarify any possible differences in biopsy lesions amongst varied demographic groups.
The authors concluded that APL Gleason Score was much better representation of final Gleason score for AA than W/O men, but AA men are no more likely to harbor positive APLs compared to W/O men.
Presented By: Michael Kongnyuy, MD
Written By: Blanca Morales, Department of Urology, University of California, Irvine at the 2016 AUA Annual Meeting - May 6 - 10, 2016 – San Diego, California, USA