Racial variations in upgraded gleason scores of active surveillance candidates.

e548 Background: Currently, active surveillance is an appropriate option for patients who have low risk PCa as determined by the NCCN as Gleason Score (GS) ≤ 6 and a PSA <10. Methods: Following IRB approval, we determined that 141 men from our database had low risk PCa and were eligible for AS, but underwent radical prostatectomy (RP). We performed a retrospective review of these patients examining GS upon RP. Disease upgrading on RP was considered Gleason score ≥ 7. A two-tailed t-test was performed to examine whether African American (AA) patients had greater incidence of upgrading on RP than non-African American patients. Results: Of the 141 patients identified (36 AA, 105 non-AA) there were no significant differences in age at RP (59 AA, 59 non-AA), median PSA (5.5 ng/dL AA, 5.4 ng/dL non-AA), and number of positive cores (3 AA, 3 non-AA) at biopsy when stratified by race. A total of 85 patients (19 AA, 66 non-AA) were found to have an upgraded GS at the time of RP; again without significant difference with respect to age (60 AA, 61 non-AA), serum PSA (5.3 AA, 5.35 non-AA), total cores taken at biopsy (12 AA, 12 non-AA) and median positive cores (3.5 AA, 3 non-AA). Of the 85 patients upgraded, 66 (12 AA, 54 non-AA) were 3+4 and the remainder were ≥ 4+3. There was no significant racial variation for patients upgraded to Gleason 3+4 (p>0.05). Next we reviewed the presence of tertiary pattern 5 within these 3+4 patients and found it present in 1 patient who was AA. For the 19 patients with ≥ 4+3 upgrading, with respect to race (7 AA, 12 non-AA, p = .08) there were no significant differences in age, serum PSA, median positive and total cores taken at biopsy. However, when comparing these 19 upgraded ≥ 4+3 patients to the total cohort, they had a higher median serum PSA (6.16 ng/dLvs 5.4 ng/dL) and higher positive cores (4 vs 3) on biopsy. For these 19 patients, upgrading resulted in reclassification from low to high-grade (GS ≥ 8) PCa in 7 patients. Conclusions: African American patients with low risk PCa have do not have an increased risk of significant upgrading at RP when compared with other races, and further investigation is needed to identify factors that contribute to upgrading.