Association of family history of cancer with clinical and pathological outcomes for prostate cancer patients on active surveillance Journal Article


Authors: Jibara, G. A.; Perera, M.; Vertosick, E. A.; Sjoberg, D. D.; Vickers, A.; Scardino, P. T.; Eastham, J. A.; Laudone, V. P.; Touijer, K.; Lin, X.; Carlo, M. I.; Ehdaie, B.
Article Title: Association of family history of cancer with clinical and pathological outcomes for prostate cancer patients on active surveillance
Abstract: Purpose:The impact of germline mutations associated with hereditary cancer syndromes in patients on active surveillance (AS) for prostate cancer is poorly defined. We examined the association between family history of prostate cancer (FHP) or family history of cancer (FHC) and risk of progression or adverse pathology at radical prostatectomy (RP) in patients on AS.Materials and Methods:Patients on AS at a single tertiary-care center between 2000-2019 were categorized by family history. Disease progression was defined as an increase in Gleason grade on biopsy. Adverse pathology was defined as upgrading/upstaging at RP. Multivariable Cox and logistic regression models were used to assess association between family history and time to progression or adverse pathology, respectively.Results:Among 3,211 evaluable patients, 669 (21%) had FHP, 34 (1%) had FHC and 95 (3%) had both; 753 progressed on AS and 481 underwent RP. FHP was associated with increased risk of progression (HR 1.31; 95% CI, 1.11-1.55; p=0.002) but FHC (HR 0.67; 95% CI, 0.30-1.50; p=0.3) or family history of both (HR 1.22; 95% CI, 0.81-1.85; p=0.3) were not. FHP, FHC or both were not associated with adverse pathology at RP (p >0.4).Conclusions:While FHP was associated with an increased risk of progression on AS, wide confidence intervals render this outcome of unclear clinical significance. FHC was not associated with risk of progression on AS. In the absence of known genetically defined hereditary cancer syndrome, we suggest FHP and/or FHC should not be used as a sole trigger to preclude patients from enrolling on AS. © 2022 Lippincott Williams and Wilkins. All rights reserved.
Keywords: cancer grading; prostate specific antigen; pathology; prostate-specific antigen; prostatic neoplasms; prostatectomy; disease progression; watchful waiting; prostate tumor; germ-line mutation; neoplastic syndromes, hereditary; neoplasm grading; humans; human; male
Journal Title: Journal of Urology
Volume: 208
Issue: 2
ISSN: 0022-5347
Publisher: Elsevier Science, Inc.  
Date Published: 2022-08-01
Start Page: 325
End Page: 332
Language: English
DOI: 10.1097/ju.0000000000002668
PUBMED: 35377777
PROVIDER: scopus
PMCID: PMC9283237
DOI/URL:
Notes: Article -- Export Date: 1 August 2022 -- Source: Scopus
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MSK Authors
  1. Vincent Laudone
    138 Laudone
  2. Peter T Scardino
    671 Scardino
  3. Karim Abdelkrim Touijer
    259 Touijer
  4. Andrew J Vickers
    887 Vickers
  5. Daniel D. Sjoberg
    234 Sjoberg
  6. Behfar Ehdaie
    175 Ehdaie
  7. James Eastham
    540 Eastham
  8. Maria Isabel Carlo
    165 Carlo
  9. Emily Vertosick
    136 Vertosick
  10. Xin Lin
    7 Lin
  11. Ghalib Jibara
    7 Jibara
  12. Marlon Lakmal Perera
    24 Perera