While family history (FHx) of prostate cancer (PCa) increases the risk of PCa, comparably less is known regarding the impact of FHx on pathologic and oncologic outcomes after radical prostatectomy (RP).
We retrospectively reviewed our multicenter database comprising 6,041 nonmetastatic PCa patients treated with RP. Patients with a FHx of PCa in one or more first-degree relatives were considered as FHx positive. We examined the association of FHx with pathologic outcomes and biochemical recurrence (BCR) using logistic and Cox regression models, respectively.
In total, 1,677 (28%) patients reported a FHx of PCa. Compared to patients without FHx, those with, were younger at RP (median age of 59 vs. 62 years, p < 0.01), and had significantlymore favorable biopsy and RP histopathologic findings. On multivariable logistic regression analysis, positive FHx was associated with extracapsular extension (odds ratio [OR] 0.77, 95% confidence interval [CI] 0.66-0.90, p < 0.01; model AUC 0.73) and upgrading (OR 0.70, 95% CI 0.62-0.80, p < 0.01; model AUC 0.68). Incorporating FHx significantly improved the AUC of the base model for upgrading (p < 0.01). Positive FHx was not associated with BCR in pre- and postoperative multivariable models (p = 0.1 and p = 0.7); c-indexes of Cox multivariable models were: 0.73 and 0.82, respectively.
We found that patients with clinically nonmetastatic PCa who have positive FHx of PCa undergo RP at a younger age and have more favorable pathologic outcomes. Nevertheless, FHx of PCa did not confer better BCR rates, suggesting that FHx leads to potentially early detection and treatment without impact on BCR.
Arab journal of urology. 2023 Apr 03*** epublish ***
Pawel Rajwa, Fahad Quhal, David D'Andrea, Stephan Korn, Patrik Petrov, Takafumi Yanagisawa, Tatsushi Kawada, Reza Sari Motlagh, Hadi Mostafaei, Ekaterina Laukhtina, Abdulmajeed Aydh, Frederik König, Maximilian Pallauf, Benjamin Pradere, Peter Nyirády, Mohammad Abufaraj, Giancarlo Marra, Giorgio Gandaglia, Alberto Briganti, Pierre Karakiewicz, Ding-Wei Ye, Martin Haydter, Piotr Chlosta, Eva Comperat, Dmitry Enikeev, Shahrokh F Shariat
Department of Urology, Medical University of Vienna, Vienna, Austria., Department of Urology, Semmelweis University, Budapest, Hungary., Department of Special Surgery, Division of Urology, Jordan University Hospital, The University of Jordan, Amman, Jordan., Department of Urology, San Giovanni Battista Hospital, University of Turin, Turin, Italy., Department of Urology and Division of Experimental Oncology, URI Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy., Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada., Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China., Department of Urology, Landesklinikum Wiener Neustadt, Vienna, Austria., Department of Pathology, Medical University of Vienna, Vienna, Austria., Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.