Familial prostate cancer: outcome following radiation therapy with or without adjuvant androgen ablation.
OBJECTIVE
To compare the outcome of familial versus sporadic prostate carcinoma after definitive external radiation.


METHODS
Between 1987 and 1996, 1214 men with clinically localized prostate cancer (T1-T4, N0/NX, M0) received definitive radiation therapy in our department. By retrospective review of charts and questioning of patients, a record on the presence or absence of prostate cancer in a first degree relative was obtained in 1164 men. Univariate and multivariate analysis was performed on these cases with relapse or rising prostate-specific antigen (PSA), local recurrence, metastasis, and survival as endpoints.


RESULTS
Familiar prostate cancer was present in 148 of 1164 men (13%). Men with familial disease were slightly but significantly younger (mean 66 years) at diagnosis than those with sporadic disease (mean 68 years) (p = 0.02). Apart from this there were no significant differences between the two groups in T-stage, Gleason score, pretreatment PSA levels, DNA ploidy, or serum testosterone levels. There were no significant differences in treatment parameters including radiation dose and the use of adjuvant androgen ablation. With a median follow-up of 42 months, there was no difference in freedom from relapse or rising PSA at 6 years between those with a family history (54%) and those without a family history (58%) (p = 0.171). Likewise there was no difference between the two groups when local recurrence or metastasis was the endpoint. Multiple subgroup analyses (younger and older; T1/T2 and T3; low Gleason and high Gleason; no androgen ablation and androgen ablation; race) failed to reveal any differences in outcome in any category between familial and sporadic disease. Among patients with a rising post-treatment PSA profile, PSA doubling times were similar in those with sporadic and familial disease.


CONCLUSIONS
This study provides no evidence for any substantial difference between familial and sporadic prostate cancer either in clinicopathological features, in response to treatment, or in ultimate outcome.
Department of Radiation Oncology, The University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
M C
MC
Hanus
G K
GK
Zagars
A
A
Pollack
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009386:Neoplastic Syndromes, Hereditary / Q000188:drug therapy / Q000235:genetics / Q000532:radiotherapy; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000235:genetics / Q000532:radiotherapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
D017430:Prostate-Specific Antigen