Family history of prostate cancer in patients with localized prostate cancer: An independent predictor of treatment outcome

被引:65
|
作者
Kupelian, PA
Kupelian, VA
Witte, JS
Macklis, R
Klein, EA
机构
[1] CLEVELAND CLIN FDN, DEPT UROL, CLEVELAND, OH 44195 USA
[2] CASE WESTERN RESERVE UNIV, DEPT EPIDEMIOL, CLEVELAND, OH 44106 USA
[3] CASE WESTERN RESERVE UNIV, DEPT BIOSTAT, CLEVELAND, OH 44106 USA
关键词
D O I
10.1200/JCO.1997.15.4.1478
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: To determine if familial prostate cancer patients have a less favorable prognosis than patients with sporadic prostate cancer after treatment for localized disease with either radiotherapy (RT) or radical prostatectomy (RP). Patients and Methods: One thousand thirty-eight patients treated with either RT (n = 583) or RP (n = 455) were included in this analysis, These patients were noted as having a positive family history if they confirmed the diagnosis of prostate cancer in a first-degree relative, The outcome of: interest was biochemical relapse-free survival (bRFS). We used proportional hazards to analyze the effect of the presence of family history and other potential confounding variables (ie, age, treatment modality, stage, biopsy Gleason sum [GS], and initial prostate-specific antigen [iPSA] levels) on treatment outcome. Results: Eleven percent of all patients had a positive family history, The 5-year bRFS rates for patients with negative and positive family histories were 52% and 29%, respectively (P < .001). The potential confounders with bRFS rates were iPSA levels, biopsy GS, and clinical tumor stage; treatment modality and age did not appear to be associated with outcome. After adjusting for potential confounders, family history of prostate cancer remained strongly associated with biochemical failure. Conclusion: This is the first study to demonstrate that the presence of a family history of prostate cancer correlates with treatment outcome in a large unselected series of patients. Our findings suggest that familial prostate cancer may have a more aggressive course than nonfamilial prostate cancer, and that clinical and/or pathologic parameters may not adequately predict this course. (C) 1997 by American Society of Clinical Oncology.
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页码:1478 / 1480
页数:3
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