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Vietnamese-American Men with Prostate Cancer Present with Worse Clinicopathologic Features Compared to the General Population

Tin C Ngo, Michael T Wu, Rajesh Shinghal and Jeffrey H Reese

Purpose: Large epidemiologic studies have suggested racial differences in the behavior of prostate cancer in Asian Americans subgroups. We studied the clinical and pathologic features of prostate cancer in Vietnamese American men.
Methods: We retrospectively reviewed our last decade of experience with prostate in Vietnamese American men and compared their baseline demographics and clinical and pathologic outcomes with Asian Americans in general and with a typical university hospital cohort.
Results: We identified 46 Vietnamese American men treated at our institution between 1999-2010. The mean age at diagnosis is 65.4 (IQR 62.8-68). The median PSA was 12.2 (IQR 6.8-19.3). Approximately half had palpable disease on digital rectal examination at the time of presentation and half had Gleason 8 or higher prostate cancer. The PSA density was also relatively high at 1.48 ng/mL2, driven in part by low prostate volumes. Despite the adverse features within this cohort including a median PSA greater than 10 and a greater proportion of patients presenting with higher clinical T stage and higher grade cancers, only one of these patients progressed to metastatic disease during the follow period and subsequently died.
Conclusions: Vietnamese American men with prostate cancer present with adverse features including higher PSA levels, higher clinical stages, and higher pathologic grades. This may be due to a lack of prostate cancer screening, genetic differences, or environmental factors. Further study is needed to evaluate the causes of these disparities.