title: Impact of a family history of prostate cancer on clinicopathologic outcomes and survival following radical prostatectomy.
abstract: OBJECTIVE
  While a family history (FH) of prostate cancer represents an established risk factor for prostate cancer diagnosis, conflicting data exist regarding the oncologic importance of FH. Herein, we evaluated the association of FH with clinicopathologic outcomes among men undergoing radical prostatectomy (RP).
  
  
  METHODS
  We identified 16,472 men who underwent RP between 1987 and 2010 at Mayo Clinic. Patients were considered to have a positive FH if at least one first-degree relative had been diagnosed with prostate cancer. Survival was estimated using the Kaplan-Meier method. The associations of FH with clinicopathologic features and survival were evaluated using logistic and Cox regression analyses.
  
  
  RESULTS
  Overall, 5323 (32.3 %) men reported a FH of prostate cancer. Median follow-up was 9.9 years (IQR 5.9, 15.5). Patients with a FH were significantly more likely to have low-risk disease (47.7 vs. 43.0 %; p < 0.0001) and were significantly more likely to have organ-confined disease at RP (79.2 vs. 74.4 %; p < 0.0001). Men with FH had a significantly higher 10-year cancer-specific (99 vs. 97 %; p < 0.001) and overall survival (92 vs. 85 %; p < 0.001) than men without FH. Moreover, on multivariable analysis, FH of prostate cancer remained independently associated with reduced cancer-specific (HR 0.68; p = 0.003) and all-cause mortality (HR 0.69; p < 0.0001).
  
  
  CONCLUSIONS
  In this surgical population, FH of prostate cancer was associated with lower-risk disease at diagnosis, more favorable pathology at RP, and significantly better cancer-specific and overall survival. These results may be utilized for patient counseling.
authors.affiliation: Department of Urology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Westerman
authors.affiliation: Department of Urology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.
authors.forename: Boris
authors.initials: B
authors.lastname: Gershman
authors.affiliation: Department of Urology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.
authors.forename: R Jeffrey
authors.initials: RJ
authors.lastname: Karnes
authors.affiliation: Department of Urology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.
authors.forename: R Houston
authors.initials: RH
authors.lastname: Thompson
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
authors.forename: Laureano
authors.initials: L
authors.lastname: Rangel
authors.affiliation: Department of Urology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA. Boorjian.Stephen@mayo.edu.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Boorjian
mesh_terms: D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000235:genetics / Q000401:mortality* / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Family history; Localized prostate cancer; Oncologic outcomes; Radical prostatectomy