Men with family history of prostate cancer have a higher risk of disease recurrence after radical prostatectomy.

PURPOSE: We aimed to determine if family history (FH) of prostate cancer (PC) influenced cancer control after radical prostatectomy (RP). METHODS: Patients were evaluated in a prospectively-collected PC family database: The focus was on hereditary prostate cancer (HPC) defined by Johns Hopkins criteria and sporadic prostate cancer (SPC), rigorously defined by absence of prostate cancer in ≥ 2 brothers aged ≥ 60 years. Additionally, patients with first-degree (FPC) and non-first-degree PC (non-FPC) were assessed. Endpoints were biochemical recurrence-free survival (BRFS) and prostate cancer-specific survival (CSS). Finally, clinico-pathological characteristics were compared and multiple proportional hazards regression was used to identify prognostic factors. RESULTS: In total 11,654 patients were included (807 HPC, 2251 FPC, 8072 non-FPC and 524 SPC). Familial imposition (HPC/FPC) was associated with a younger age at diagnosis. Thus, HPC patients were diagnosed 2.9 years earlier than SPC patients with more locally advanced tumors (≥ pT3). With a median follow up of 6.2 years (range 0-31.5) BRFS was significantly different when stratified by FH. In pairwise analyses BRFS differed significantly for HPC compared to SPC (HR = 1.27). Consecutively FH was identified as prognostic factor for BRFS (p = 0.021) together with age, PSA, pathologic characteristics and adjuvant androgen deprivation. Analyses of CSS did not show a difference. CONCLUSION: Patients with FH of PC are likely to be diagnosed earlier and present a higher proportion of locally advanced disease. In addition, men with FH are at higher risk of biochemical recurrence after surgery but reveal similar outcomes regarding prostate cancer-specific survival.

No Detrimental Effect of a Positive Family History on Long-Term Outcomes Following Radical Prostatectomy.

PURPOSE: Overall 1 in 5 patients with prostate cancer has a positive family history. In this report we evaluated the association between family history and long-term outcomes following radical prostatectomy. MATERIALS AND METHODS: Patients treated with radical prostatectomy were identified from a German registry, and separated into positive first-degree family history vs negative family history (strictly negative, requiring at least 1 male first-degree relative older than 60 years and no prostate cancer in the family). Kaplan-Meier curves and Cox proportional hazards models were used for association analyses with biochemical recurrence-free and prostate cancer specific survival. RESULTS: Median followup for 7,690 men included in the study was 8.4 years. Of the 754 younger patients less than 55 years old 50.9% (384) had a family history compared to 40.4% of the older patients (2,803; p <0.001). The 10-year biochemical recurrence-free (62.5%) and prostate cancer specific survival (96.1%) rates did not differ between patients with vs without a family history, nor between the younger vs older patient groups (all p >0.05). Prostate specific antigen, pathological stage, node stage and Gleason score were the only significant predictors for biochemical recurrence-free survival, while pathological stage, node stage (all p <0.005) and Gleason score (Gleason 7 vs 6 or less-HR 1.711, 95% CI 1.056-2.774, p = 0.03; Gleason 8 or greater vs 6 or less-HR 4.516, 95% CI 2.776-7.347, p <0.0001) were the only predictors for prostate cancer specific survival. CONCLUSIONS: A family history of prostate cancer has no bearing on long-term outcomes after radical prostatectomy.