Oncology The Effect of Race/Ethnicity on the Accuracy of the 2001 Partin Tables for Predicting Pathologic Stage of Localized Prostate Cancer Elisabeth I. Heath, Michael W. Kattan, Isaac J. Powell, Wael Sakr, Timothy C. Brand, Benjamin A. Rybicki, Ian M. Thompson, William J. Aronson, Martha K. Terris, Christopher J. Kane, Joseph C. Presti, Jr., Christopher L. Amling, and Stephen J. Freedland OBJECTIVES To test the accuracy of the 2001 Partin Tables in African American men who underwent radical prostatectomy at multiple centers throughout the United States. METHODS We compiled a large multiethnic cohort of men (n = 3748) treated with radical prostatectomy at multiple sites, including all of the sites of the Department of Veterans Affairs– based Shared Equal Access Regional Cancer Hospital (SEARCH) database (n = 1524), Wayne State Uni- versity (n = 1305), the University of Texas Health Science Center (n = 522), and the Henry Ford Hospital (n = 397). We evaluated the accuracy of the 2001 Partin Tables using area under the receiver operator characteristic curve (AUC) separately among African American and white men. RESULTS African American men (n = 1188, 32%), despite being more likely to have clinical Stage T1c disease (56% versus 47%, chi-square P 0.001), had higher preoperative PSA values (9.1 versus 7.7 ng/mL, rank-sum P 0.001) and were more likely to have higher-grade disease on diagnostic biopsy (chi-square P = 0.005). Despite these differences in baseline clinical characteristics, the 2001 Partin Tables performed equally well in both racial groups. Specifically, there were no differences in the AUC for African American and white men for predicting organ-confined disease (AUC 0.73 versus 0.72; P = 0.56), extraprostatic extension (AUC 0.62 versus 0.62; P = 0.99), or seminal vesicle invasion (AUC 0.77 versus 0.79; P = 0.53). CONCLUSIONS These data lend further support to the idea that although baseline differences between the races existed that may underlie an overall more aggressive disease among African American men, for the individual patient, race is not valuable for prognostication. UROLOGY 71: 151–155, 2008. © 2008 Elsevier Inc. P rostate cancer is the most common malignancy and second leading cause of cancer deaths among men in the United States. 1 African American men present with higher prostate-specific antigen (PSA) levels, higher disease grades, and more advanced disease and have a nearly twofold higher mortality than white men. 2 The reasons for this disparity are not well understood. Socioeconomic fac- tors hindering accessibility to prostate screening and appro- priate medical treatment and racial differences in cancer biology are likely contributors to this disparity. 3– 6 Although African American men often have poorer outcomes than white men, race is not routinely utilized in clinical decision making. There are numerous pub- lished nomograms available to clinicians for estimating prostate cancer outcomes, 7 including the first published and one of the most widely used nomograms, the Partin Tables. 8,9 The Partin Tables utilized serum PSA value, Gleason score, and clinical stage to preoperatively pre- dict final pathologic stage at the time of radical prosta- tectomy. 8,9 A recently updated version of the Partin tables remains as accurate as the original. 9 To better understand racial disparity in prostate can- cer, it is critical that these clinical nomograms be vali- Supported by the Fund for Cancer Research, the Karmanos Cancer Institute (Detroit, Michigan), the U.S. Department of Defense, the U.S. Department of Veterans Affairs, the Georgia Cancer Coalition, the National Institutes of Health, and the American Urological Association Astellas Rising Star in Urology Award. From the Barbara Ann Karmanos Cancer Institute, Detroit, Michigan; Cleveland Clinic, Cleveland, Ohio; The University of Texas Health Science Center at San Antonio, San Antonio, Texas; Department of Biostatistics and Research Epidemiology, Henry Ford Health System, Detroit, Michigan; Greater Los Angeles Department of Veterans Affairs (VA) and University of California, Los Angeles, Los Angeles, California; Augusta VA and Medical College of Georgia, Augusta, Georgia; San Francisco VA and University of California, San Francisco, San Francisco, California; Stanford University and Palo Alto VA, Palo Alto, California; University of Alabama Birmingham and Birmingham VA, Birmingham, Alabama; and Durham VA and Duke University, Durham, North Carolina Reprint requests: Elisabeth I. Heath, M.D., Karmanos Cancer Institute, Depart- ment of Hematology and Oncology, Wayne State University, 4100 John R, 4 HWCRC, Detroit, MI 48201. E-mail: heathe@karmanos.org Submitted: April 19, 2007, accepted (with revisions): August 10, 2007 © 2008 Elsevier Inc. 0090-4295/08/$34.00 151 All Rights Reserved doi:10.1016/j.urology.2007.08.016