Ethnicity Based Analysis of Prostatectomy Specimens and PSA Outcomes: Results from the NCI Cooperative Prostate Cancer Tissue Resource
Milton W. Datta2, Mike Becich3, Maarten Bosland1, Rajiv Dhir3, Andre Kajdacsy-Balla2, Jonathan Melamed1, Jan Orenstein4, Sylvia Silver4, Jules Berman5, and the Cooperative Prostate Cancer Tissue Resource.
Departments of Pathology, 1New York University School of Medicine, New York, NY, 2Medical College of Wisconsin, Milwaukee, WI, 3University of Pittsburgh, Pittsburgh, PA, 4George Washington University, Washington D.C., and 5National Cancer Institute, Bethesda, MD.
The NCI-funded Cooperative Prostate Cancer Tissue Resource (http://www.prostatetissues.org ) contains over 3300 prostate cancer cases, including 2892 prostatectomy specimens from 12 hospitals representing four separate academic institutions. In each case the pathologic specimens were reviewed by a panel of academic pathologists using defined criteria as established by the AFIP Prostate Fascicle (third series) and the Gleason grading web site at Johns Hopkins University (http://220.127.116.11/prostate/ ). The dataset includes people of the following defined ethnicity/race; 1883 Caucasians, 420 African-Americans, 57 Hispanic, 25 Asians/pacific islanders. The mean patient age is 62.7 years (range 35 to 85 years). An analysis of both pathologic, clinical, and outcomes parameters with respect to ethnicity have been performed. There was no significant difference identified between individual ethnicity and overall family history of prostate cancer, prostate weight, extraprostatic extension of tumor, Gleason score, order of Gleason score 7 tumors (i.e. 3+4 vs. 4+3), pathologic stage, or vital status. African Americans were slightly more likely to have positive surgical margins at prostatectomy (p<0.01). PSA recurrence data was calculated on 909 patients with a minimum of 3 follow-up PSA values and a mean follow-up period of 36 months. In this dataset African-Americans were more likely than Caucasians to have post-prostatectomy residual tumor (p<0.001) and PSA recurrence (p<0. 001), but there was no significant difference between elevated post-surgical PSA values and positive surgical margins. People identifying themselves as Hispanic were slightly more likely to have post-prostatectomy residual tumor (p<0.01). There was no association between Hispanic identifiers and PSA recurrence. Thus despite similar overall pathologic and clinical characteristics, African-American men are more likely to have elevated PSA values post-prostatectomy. These samples are a component of the NCI-funded Cooperative Prostate Cancer Tissue Resource, and thus will become available for tissue based prostate cancer studies through such technologies as tissue microarrays for the discovery of biomarkers that may identify these ethnicity-based differences.