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- Title:
No detrimental effect of a positive family history on postoperative upgrading and upstaging in men with low risk and favourable intermediate-risk prostate cancer: implications for active surveillance.
- Document type:
- Article; Journal Article
- Author(s):
- Herkommer, Kathleen; Maier, Nikola; Ankerst, Donna P; Schiele, Stefan; Gschwend, Jürgen E; Meissner, Valentin H
- Abstract:
- PURPOSE: To assess whether a first-degree family history or a fatal family history of prostate cancer (PCa) are associated with postoperative upgrading and upstaging among men with low risk and favourable intermediate-risk (FIR) PCa and to provide guidance on clinical decision making for active surveillance (AS) in this patient population. METHODS: Participants in the German Familial Prostate Cancer database diagnosed from 1994 to 2019 with (1) low risk (clinical T1c-T2a, biopsy Gleason Grade Group (GGG) 1, PSA < 10 ng/ml), (2) Gleason 6 FIR (clinical T1c-T2a, GGG 1, PSA 10-20 ng/ml), and (3) Gleason 3 + 4 FIR (clinical T1c-T2a, GGG 2, PSA < 10 ng/ml) PCa who were subsequently treated with radical prostatectomy (RP) were analysed for upgrading, defined as postoperative GGG 3 tumour or upstaging, defined as pT3-pT4 or pN1 disease at RP. Logistic regression analysis was used to assess whether PCa family history was associated with postoperative upgrading or upstaging. RESULTS: Among 4091 men who underwent RP, mean age at surgery was 64.4 (SD 6.7) years, 24.7% reported a family history, and 3.4% a fatal family history. Neither family history nor fatal family history were associated with upgrading or upstaging at low risk, Gleason 6 FIR, and Gleason 3 + 4 FIR PCa patients. CONCLUSION: Results from the current study indicated no detrimental effect of family history on postoperative upgrading or upstaging. Therefore, a positive family history or fatal family history of PCa in FIR PCa patients should not be a reason to refrain from AS in men otherwise suitable.
- Journal title abbreviation:
- World J Urol
- Year:
- 2021
- Journal volume:
- 39
- Journal issue:
- 7
- Pages contribution:
- 2499-2506
- Fulltext / DOI:
- doi:10.1007/s00345-020-03485-5
- Pubmed ID:
- http://view.ncbi.nlm.nih.gov/pubmed/33048258
- Print-ISSN:
- 0724-4983
- TUM Institution:
- Urologische Klinik und Poliklinik
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