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

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Abstract

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.

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Authors and Affiliations

  1. Department of Urology, Urologische Klinik und Poliklinik, der Technische Universität München, Klinikum rechts der Isar, Ismaninger Str. 22, 81675, Munich, Germany

    Mark Thalgott, Johannes M. Brath, Juergen E. Gschwend & Kathleen Herkommer

  2. Institute of Biometrics, University of Ulm, Ulm, Germany

    Martina Kron

  3. Departments of Life Sciences and Mathematics of the Technical University Munich, Munich, Germany

    Donna P. Ankerst

  4. Department of Urology, University of Texas Health Science Center at San Antonio, Cancer Therapy and Research Center, San Antonio, USA

    Ian M. Thompson

Authors
  1. Mark Thalgott
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  2. Martina Kron
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  3. Johannes M. Brath
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  4. Donna P. Ankerst
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  5. Ian M. Thompson
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  6. Juergen E. Gschwend
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  7. Kathleen Herkommer
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Contributions

M Thalgott: Manuscript writing, Project development. M Kron: Data analysis, Data management, Manuscript editing. JM Brath: Data collection. DP Ankerst: Data analysis, Manuscript editingIM Thompson: Manuscript editing. JE Gschwend: Protocol development. K Herkommer: Protocol and project development, Manuscript editing.

Corresponding author

Correspondence to Mark Thalgott.

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Funding

No funding was received for this study.

Conflict of interest

The authors declare no potential conflict of interest related to this article.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Thalgott, M., Kron, M., Brath, J.M. et al. Men with family history of prostate cancer have a higher risk of disease recurrence after radical prostatectomy. World J Urol 36, 177–185 (2018). https://doi.org/10.1007/s00345-017-2122-5

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  • DOI: https://doi.org/10.1007/s00345-017-2122-5

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