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Similar QOL after radical prostatectomy in Blacks and Caucasians

NEW YORK (Reuters Health) – Health-related quality-of-life (QOL) after radical prostatectomy is similar for African-American and Caucasian men, according to a report in the March 19th online BJU International.

“We know that the African American male pelvis is narrower and that this makes the radical prostatectomy a bit more challenging,” Dr. Herbert Lepor from New York University School of Medicine, New York told Reuters Health in an email. “However, it was not apparent whether the technically more challenging procedure would impact critical outcomes like surgical margins, incontinence and erectile dysfunction. Fortunately, outcomes were not compromised in African American men.”

Dr. Lepor and colleagues compared urinary and sexual health-related quality-of-life measures between 56 African American and 1338 Caucasian American men who underwent open retropubic radical prostatectomy by a single surgeon using a standard surgical technique.

Perioperative outcomes (estimated blood loss, nerve sparing, transfusions, and major complications) and adjuvant therapy rates did not differ between the African American and Caucasian men.

UCLA Prostate Cancer Index scores at 24 months, including those for urinary function, urinary bother, sexual function, and sexual bother, were also similar in the two groups.

American Urological Association (AUA) Symptom Scores at 24 months were similar, as were the percentages of men in both groups who reported being very satisfied, satisfied, or unsatisfied 24 months after surgery.

“I believe the press has exaggerated the limits of prostate cancer screening while over-stating the complications of radical prostatectomy,” Dr. Lepor said. “I have previously reported that 93% of those men who I performed radical prostatectomy are satisfied with their outcomes. The overwhelming majority are cured, almost all are continent and many enjoy good sexual function.”

“African American men are at greater risk of developing and dying from prostate cancer,” Dr. Lepor said. “In expert hands, their outcomes following radical prostatectomy are excellent.”

He added, “Over the past 11 years, I have enrolled almost 2000 of my patients who have undergone radical prostatectomy into an IRB-approved prospective outcomes study. We have hundreds of men who have completed quality of life questionnaires prior to and throughout 10 years of follow up. There is no database like this in the world. As we speak, we are analyzing the 10 years outcomes, focusing on continence and erectile function.”


BJU Int 2012.