AUA 2018: Is Fatal Family History in Prostate Cancer a Predictor of Radical Prostatectomy Outcomes?

San Francisco, CA (UroToday.com) It is well known that a family history of prostate cancer, particularly of advanced or fatal disease, increases a man’s chance of being diagnosed with prostate cancer. In this single center study from Munich, Germany which was presented as a moderated poster at the American Urologic Association Annual Meeting, Dr. Herkommer and colleagues assessed the association between a first-degree family history of fatal prostate cancer and outcomes following radical prostatectomy for men diagnosed with prostate cancer. 



Assessing 1,076 patients who underwent radical prostatectomy, Dr. Herkommer and colleagues identified those with no family history of fatal prostate cancer, those with a fraternal history of fatal prostate cancer, those a paternal history of fatal prostate cancer, and those with multiple first-degree relatives with fatal prostate cancer. The authors then compared clinicopathologic characteristics and survival outcomes among these groups. 

Interestingly, patients with a family history notable for fraternal or multiple fatal prostate cancer events were older at the time of surgery (64.7 and 64.3 years, respectively, compared with 62 years in patients with no fatal family history). These patients had higher PSA levels at the time of surgery. Additionally, they had worse pathologic features: a higher rate of non-organ confined disease, higher rate of nodal involvement, and higher rates of Gleason score ≥7 (4+3). However, multivariable analyses were not undertaken. 

As may be expected from a modern prostatectomy cohort, cancer specific survival was excellent – 98.1% and 95.7% at 10 and 15 years, respectively, among the whole cohort. Despite the differences in pathologic characteristics, biochemical recurrence free survival, cancer specific survival, and overall survival did not differ among the groups. As with the analysis of pathologic characteristics, multivariable analyses were not undertaken.  

The authors conclude that a family history of fatal prostate cancer in a first-degree relative is not associated with worse clinical outcomes following radical prostatectomy. These data may be useful in reassuring patients for whom family members have died of prostate cancer. 

Presented By: Kathleen Herkommer 
Co-authors: Jamila Strüh, Martina Kron, Stephanie Kranz, Silvia Sander, Jürgen Gschwend 

Written by: Christopher J.D. Wallis, Urology Resident, University of Toronto, Twitter: @WallisCJDat the 2018 AUA Annual Meeting - May 18 - 21, 2018 – San Francisco, CA USA
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