African American Men with Gleason Score 3+3=6 Prostate Cancer Produce Less PSA Than Caucasian Men: A Potential Impact on Active Surveillance.

To assess the difference in PSA production between African Americans (AA) and Caucasians with Gleason score 3+3=6 prostate cancer (PCa).

We measured tumor volume in 414 consecutive radical prostatectomies (RP) from men with NCCN low risk PCa (348 Caucasians, 66 AA) who had Gleason score 3+3=6 at RP.

We then compared clinical presentation, pathologic findings, PSA, PSA density (PSAD), and PSA mass (PSAM - an absolute amount of PSA in patient's circulation) between AA and Caucasians. T-test was used for comparison of means.

AA and Caucasians had similar clinical findings in their age, body mass index (BMI), and PSA. There were no statistically significant differences between the dominant tumor nodule and total tumor volumes (mean, 0. 712 vs. 0. 665 cm(3), p=0. 695) between AA and Caucasians. Prostates were heavier in AA (mean, 55. 4 vs. 46. 3 gm. ; p=

AA men with Gleason score 3+3=6 PCa produce less PSA than Caucasians. AA and Caucasians had equal serum PSA levels and PSAM despite significantly larger prostates in AA with all other parameters, particularly total tumor volume, being the same. This has practical implications in T1c patients diagnosed with PCa due to PSA screening. Lowering PSAD threshold in AA men may account for this disparity, particularly in selecting patients for active surveillance programs.

The Journal of urology. 2015 Sep 01 [Epub ahead of print]

Oleksandr N Kryvenko, Raymond Balise, Nachiketh Soodana Prakash, Jonathan I Epstein

Departments of Pathology, University of Miami Miller School of Medicine, Miami, FL; Departments of Urology, and University of Miami Miller School of Medicine, Miami, FL.  Departments of Urology, and University of Miami Miller School of Medicine, Miami, FL; Departments of Biostatistics, University of Miami Miller School of Medicine, Miami, FL. , Departments of Urology, and University of Miami Miller School of Medicine, Miami, FL. , Departments of Pathology, Urology, and Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD.

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