Institute of Pathology, St. Luke's Medical Center-Global City, Taguig, Metro Manila 1634, Philippines.
Department of Pathology, The University of Chicago, Chicago, IL 60637, USA.
Asian J Androl. 2021 Sep-Oct;23(5):516-519. doi: 10.4103/aja.aja_9_21.
Lower incidence and mortality rates from prostate cancer (PCa) have been shown in Asian men in general compared to Westerners. This is the first study detailing the clinicopathologic features of resected prostate cancer in Filipino men living in the Philippines (PH). This study investigated the supposed "lower risk" Filipino and "higher risk" American PCa patients from the PH and the United States of America (USA), respectively. We examined 348 (176 from PH, 172 from USA) radical prostatectomy cases. The clinicopathologic features of both groups (age at time of diagnosis, preoperative prostate-specific antigen [pre-op PSA] level, Gleason score [GS], Grade groups [GG], margin involvement, extraprostatic extension [EPE], seminal vesicle invasion [SVI], and regional lymph node [RLN] metastasis) were compared. Six of seven prognosticators examined were more strongly associated with Filipinos than with Americans. Filipinos were older at diagnosis (PH: 64.32 ± 6.56 years vs USA: 58.98 ± 8.08 years) and had higher pre-op PSA levels (PH: 21.39 ± 46.40 ng ml vs USA: 7.63 ± 9.19 ng ml). Filipino men had more advanced grade, GG 2 with minor pattern 5 (PH: 6.2% vs USA: 2.9%) and GG 5 (PH: 14.8% vs USA: 3.5%). Likewise, other adverse pathological features in margin positivity (PH: 52.3% vs USA: 23.8%), focal EPE (PH: 14.2% vs USA: 2.3%), and SVI (PH: 17.1% vs USA: 5.8%) were more commonly observed in Filipinos. This study reveals the prognostic disadvantage of Filipinos versus Americans and highlights an important difference of Filipinos from other studied Asian ethnicities that have repeatedly been shown to have lower-risk PCa. This study, the first on Filipino PCa patients with RP, suggests the need to modify Western-based risk stratification when employed in other countries like the PH.
与西方人相比，亚洲男性的前列腺癌（PCa）发病率和死亡率普遍较低。这是第一项详细描述菲律宾男性前列腺癌切除术后临床病理特征的研究，这些男性居住在菲律宾（PH）。本研究分别调查了 PH 和美利坚合众国（USA）中所谓的“低风险”菲律宾人和“高风险”美国人 PCa 患者。我们检查了 348 例（PH 组 176 例，USA 组 172 例）根治性前列腺切除术病例。比较了两组的临床病理特征（诊断时的年龄、术前前列腺特异性抗原[pre-op PSA]水平、Gleason 评分[GS]、分级组[GG]、边缘受累、前列腺外扩展[EPE]、精囊侵犯[SVI]和区域淋巴结[RLN]转移）。检查的七个预后因素中有六个与菲律宾人关系更密切，而与美国人关系不密切。菲律宾人诊断时年龄更大（PH：64.32±6.56 岁 vs USA：58.98±8.08 岁），术前 PSA 水平更高（PH：21.39±46.40ng/ml vs USA：7.63±9.19ng/ml）。菲律宾男性的 GG 分级更高，GG2 中有小形态 5（PH：6.2% vs USA：2.9%）和 GG5（PH：14.8% vs USA：3.5%）。同样，边缘阳性（PH：52.3% vs USA：23.8%）、局灶性 EPE（PH：14.2% vs USA：2.3%）和 SVI（PH：17.1% vs USA：5.8%）等其他不良病理特征在菲律宾人中更为常见。本研究揭示了菲律宾人与美国人相比预后不利的情况，并强调了菲律宾人与其他研究的亚洲种族之间的重要差异，这些亚洲种族的 PCa 一直被认为风险较低。本研究是第一项关于菲律宾前列腺癌患者接受 RP 的研究，表明在 PH 等其他国家使用西方风险分层时需要进行修改。
