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Sandy Srinivas, MD


AACR 2023: Racial Disparity in Outcomes After Prostatectomy

By: Amanda E. Ruffino, BA
Posted: Monday, April 17, 2023

Pin Li, PhD, of Henry Ford Health, Detroit, and colleagues conducted a large cohort study and examined the biochemical recurrence rate after radical prostatectomy in Black and White patients with clinically localized prostate cancer. Presented at the American Association for Cancer Research (AACR) Annual Meeting 2023 (Abstract 747/15), these results demonstrated that Black individuals had a better recurrence-free survival rate than their White counterparts after undergoing prostatectomy, which seems to contradict a commonly held belief. 

The study included 1,020 Black and 1,263 White patients who underwent radical prostatectomy. Demographic and clinicopathologic characteristics were compared between the groups. Black patients were younger at the time of prostatectomy (60.5 vs. 62 years), had higher preoperative prostate-specific antigen levels (5.7 vs. 5.3 ng/mL), experienced fewer Gleason grade 5 (7.9% vs. 13.3%) and lymph node metastases (6.1% vs. 9.5%), and waited longer from biopsy to prostatectomy (3 vs. 2.3 months), all of which were statistically significant. Of note, longer recurrence-free survival (16 vs. 15.6 years, P = .005) and higher 5-year recurrence-free survival rates (0.82 vs. 0.71) were observed in Black compared with White patients. Black patients had a better recurrence-free survival rate than their White counterparts (hazard ratio = 1.25, P = .05), after the investigators adjusted for known prognostic factors. Additionally, for those who had multiple biopsies before prostatectomy, Gleason grade levels increased with time for Black patients (0.15 per year, P = .005) but not for White patients (–0.11 per year, P = .06).

These results differed from what was expected, the investigators noted, given that Black individuals have a higher mortality rate from prostate cancer than their White counterparts because of socioeconomic factors. The findings also support the presence of underlying biological differences of prostate cancer these groups, and they require further investigation.

Disclosure: For full disclosures of the study authors, visit

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