Comparison of health-related quality-of-life outcomes for African-American and Caucasian-American men after radical prostatectomy

Authors


Herbert Lepor, Department of Urology, NYU Langone Medical Center-, NYU Urology Associates, 150 East 32nd Street, 2nd Floor, New York, NY 10016, USA. e-mail: herbert.lepor@nyumc.org

Abstract

Study Type – Therapy (outcomes)

Level of Evidence 2c

What's known on the subject? and What does the study add?

In addition to a higher prevalence and biological aggressiveness of prostate cancer, African-Americans tend towards narrower pelvises than Caucasians resulting in a potentially more difficult surgical dissection doing radical prostatectomy and increased positive surgical margins. In this study, there was no difference in urinary or sexual HRQL or overall satisfaction between African-Americans and Caucasians 2 years after radical prostatectomy, suggesting that the potential technical challenges of a narrower pelvis do not translate into poorer outcomes for African-Americans.

OBJECTIVE

  • • To determine if any differences exist in postoperative health-related quality-of-life (HRQL) outcomes, e.g. erectile function and continence, after radical prostatectomy (RP) in African-American (AA) vs Caucasian-American (CA) men.

PATIENTS AND METHODS

  • • Between October 2000 and July 2008, 1338 CA and 56 AA men underwent open RP by a single surgeon and signed informed consent to participate in a prospective longitudinal outcomes study.
  • • The American Urological Association Symptom Score (AUA-SS) and University of California, Los Angeles, Prostate Cancer Index (UCLA-PCI) and a global assessment of satisfaction were self-administered at baseline and after RP 24 months.
  • • Urinary, sexual, and satisfaction outcomes were compared at 24 months.

RESULTS

  • • AA men had significantly higher rates of hypertension and diabetes.
  • • There were no other significant baseline differences in age, co-morbidities, body mass index, phosphodiesterase type 5 inhibitor use, preoperative prostate-specific antigen level, AUA-SS, and UCLA-PCI scores.
  • • There were no differences in the percentage of men undergoing nerve-sparing procedures, estimated blood loss, transfusion rates, or complication rates between the groups.
  • • At 24 months after RP the mean UCLA-PCI urinary and sexual function and bother scores and global satisfaction scores were similar between the groups.

CONCLUSION

  • • AA and CA men experience no significant differences in urinary and sexual HRQL or overall satisfaction after open RP when performed by a single experienced surgeon.

Ancillary