Accounting For Improved Prostate Cancer Mortality Outcomes In Haitian Men: A Histological Analysis.

e16557 Background: In a previous wide-ranging study on the outcomes of prostate cancer patients at a safety-net hospital, we discovered significantly improved mortality outcomes for Haitian Creole prostate cancer patients compared to all other languages spoken, including black English speakers, with p = 0.017 [Rand, AE, et al., Clin Genitourin Cancer. (6):455-60 (2014)]. In order to assess any molecular indications that could be contributing to this finding, we performed a histological analysis of prostate cancer specimens, comparing black English-speaking patients to Haitian Creole patients. Methods: We sampled prostatectomies from 34 black English-speaking patients and 38 black Haitian Creole-speaking patients, taken between December 2011 and June 2015. In addition to primary and secondary Gleason scores, extraprostatic extension (EPE), seminal vesicle invasion (SVI), lymphovascular invasion (LVI), and perineural invasion (PNI), we observed any small amounts of grade 5 tissue present for the tertiary Gleason score. Finally, we analyzed the presence of acute and chronic inflammation and inflammatory severity. A chi square analysis was used to compare the categories between the Haitian and non-Haitian sets, with a probability less than 0.05 considered statistically significant. Results: While the null hypothesis was confirmed for primary, secondary, and total Gleason scores, 23.7% of the Haitian samples had a tertiary Gleason score of 5, compared to only 6.3% of non-Haitian samples (p = 0.046). The two populations exhibited similar rates of EPE (p = 0.719), SVI (p = 0.884), and PNI (p = 0.597), with no LVI apparent in any sample. No significant trends were noted in acute vs. chronic inflammation (p = 0.402) or severity of inflammation (p = 0.601). Conclusions: Samples taken from Haitian Creole-speaking patients had a significantly higher rate of grade 5 tertiary Gleason tissue than the non-Haitian patient samples. The presence of a tertiary Gleason score indicates a higher risk of metastasis, yet the Haitian samples do not reveal a greater rate of extraprostatic invasion. Further studies investigating underlying health factors among Haitian patients might be useful in accounting for improved patient outcomes.