Positive family history of prostate cancer not associated with worse outcomes after radical prostatectomy.
OBJECTIVE
To determine the clinical outcomes in men with (FH) and without (NFH) a family history of prostate cancer after radical prostatectomy.


METHODS
We performed a retrospective analysis of 557 men with localized prostate cancer treated by radical prostatectomy between 1989 and 2000. We defined a positive FH as having one or more first-degree relatives such as a father or brother with prostate cancer. The clinical and pathologic features, as well as biochemical disease-free survival, defined as an undetectable prostate-specific antigen level (less than 0.2 ng/mL), were compared between the FH and NFH groups.


RESULTS
Compared with the NFH group, the FH men were younger at surgery (median 62 years versus 64 years, P = 0.01), had a lower median preoperative prostate-specific antigen level (7.2 ng/mL versus 7.8 ng/mL, P = 0.05), and were more likely to have only low-grade disease at the final pathologic evaluation (26.2% versus 17.8%, P = 0.05). At a median follow-up of 7.5 years (mean 7.6 +/- 2.9 years), 17% of the FH group had biochemical disease recurrence compared with 30% in the NFH group. The actuarial disease-free survival rate at 5 and 10 years for the two groups was 86% and 80% compared with 73% and 66%, respectively (P = 0.01). When controlled for pathologic variables in a multivariate analysis, FH was not an independent predictor of disease-free survival.


CONCLUSIONS
The association of improved disease-free survival in the FH patients may have been driven by an earlier age at diagnosis and more favorable pathologic features.
Lee
Keith L
KL
Division of Urologic Oncology, Department of Urology, Stanford University School of Medicine, Stanford, California 94305-5826, USA.
Marotte
Jeffrey B
JB
Ferrari
Michelle K
MK
McNeal
John E
JE
Brooks
James D
JD
Presti
Joseph C
JC
D000206:Actuarial Analysis; D000230:Adenocarcinoma / Q000235:genetics* / Q000401:mortality / Q000601:surgery; D000368:Aged; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D011468:Prostatectomy / Q000706:statistics & numerical data; D011471:Prostatic Neoplasms / Q000235:genetics* / Q000401:mortality / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome