Presentation Authors: Melanie Percot*, Pointe-A-Pitre/Abymes, France, Gregoire Robert, Jean Philippe Le Pailh, Bordeaux, France - Metropolitan, Gautier Stempfer, Pascal Blanchet, Remi Eyraud, Pointe-A-Pitre/Abymes, France
Introduction: Prostate cancer (PCa) is supposedly more agressive among Afro-caribbean men (ACM). We compared oncologic results of active surveillance (AS) in ACM with Caucasian men (CM).
Methods: We included all consecutive patients who underwent AS in two french centers, 261 ACM between 2005 and 2018 versus 175 CM between 2006 and 2018.Most patients were diagnosed with very low risk PCa (french criterias). Treatment occured in case of histological, biological, MRI progression, or patient demand.We described the curative treatment applied, and analysed histological characteristics after prostatectomy.AS, overall, specific, biochemical recurrence after treatment and metastasis free survivals were compared with the Kaplan-Meier method.
Results: 84.3% ACM and 89.4% CM had very low risk PCa. Median age was 65.3 and 64.6 years, median follow up was 56 and 52 months, respectively.During this time, 48% of ACM and 67% of CM remained on AS. Median AS survival was 58 months for ACM, and not reached at 130 months for CM (fig1).Proportion of patients with biopsic tumoral length progression leading to curative treatment was significatively higher for ACM, 53% versus 37% (p < 0.05).81% of ACM and 62% of CM who underwent treatment had surgery. Poor histological prognosis factors were found in 57.1% of ACM versus 29.9% of CM after prostatectomy (p < 0.05). Stratification with the CAPRA-S score showed no significative difference (p=0.86) (fig2).Overall (p=0.53), Specific (p=0.21), biochemical recurrence free (p=0.92) and metastasis free (p=0.44) survivals were not significatively different.
Conclusions: In our bi-centric study, oncologic outcomes in AS are similar, concerning mortality, recurrence and metastasis, showing availability of actual criterias for ACM. Regarding the higher rate of disease progression in Afro-caribbean population, close monitoring is recommended.