Prostate Cancer Outcomes: Evaluation of Gleason Score and Race
Posted: Wednesday, February 13, 2019
Although the Gleason score is commonly used as an independent predictor of prostate cancer outcomes, its role in predicting outcomes in black men with prostate cancer is less clear. Brandon A. Mahal, MD, of the Harvard Radiation Oncology Program, Boston, and colleagues presented study findings “supporting the hypothesis that low-grade prostate cancer may be distinct in black men” in a research letter to The Journal of the American Medical Association.
The data analyzed were collected from the Surveillance, Epidemiology, and End Results (SEER) Prostate Active Surveillance/Watchful Waiting (AS/WW) database, which included 192,224 men diagnosed with prostate cancer. Of the patient mortality data assessed, 31,841 were black and 160,383 were not black. Prostate cancer deaths for patients with Gleason score 6 disease were seen in 0.40 % of the black patients and 0.22 % of the patients who were not black. For patients with Gleason score 7 to 10 disease, mortality occurred in 1.44 % of black patients and 1.35 % of patients who were not black.
According to the researchers, although overall mortality rates were not statistically significant, “racial disparities were greatest in low-grade Gleason 6 disease, in which black men were twice as likely to die of prostate cancer compared [with] nonblack men,” they stated. Although the use of the SEER AS/WW database improved evaluation of socioeconomic and treatment selection differences in patients, further studies are needed to understand the impact of other factors, including patient characteristics, biopsy, and patterns of care, on prostate cancer-specific mortality. In addition, “these findings demonstrate the need to further study and characterize low-grade disease in black men,” the authors added.
Disclosure: The study authors reported no conflicts of interest.
