Brath Johannes M S, Grill Sonja, Ankerst Donna P, Thompson Ian M, Gschwend Juergen E, Herkommer Kathleen
Department of Urology, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany.
Departments of Life Sciences and Mathematics, Technische Universitaet Muenchen, Munich, Germany.
J Urol. 2016 Feb;195(2):343-8. doi: 10.1016/j.juro.2015.07.097. Epub 2015 Jul 31.
Overall 1 in 5 patients with prostate cancer has a positive family history. In this report we evaluated the association between family history and long-term outcomes following radical prostatectomy.
Patients treated with radical prostatectomy were identified from a German registry, and separated into positive first-degree family history vs negative family history (strictly negative, requiring at least 1 male first-degree relative older than 60 years and no prostate cancer in the family). Kaplan-Meier curves and Cox proportional hazards models were used for association analyses with biochemical recurrence-free and prostate cancer specific survival.
Median followup for 7,690 men included in the study was 8.4 years. Of the 754 younger patients less than 55 years old 50.9% (384) had a family history compared to 40.4% of the older patients (2,803; p <0.001). The 10-year biochemical recurrence-free (62.5%) and prostate cancer specific survival (96.1%) rates did not differ between patients with vs without a family history, nor between the younger vs older patient groups (all p >0.05). Prostate specific antigen, pathological stage, node stage and Gleason score were the only significant predictors for biochemical recurrence-free survival, while pathological stage, node stage (all p <0.005) and Gleason score (Gleason 7 vs 6 or less-HR 1.711, 95% CI 1.056-2.774, p = 0.03; Gleason 8 or greater vs 6 or less-HR 4.516, 95% CI 2.776-7.347, p <0.0001) were the only predictors for prostate cancer specific survival.
A family history of prostate cancer has no bearing on long-term outcomes after radical prostatectomy.
总体而言，五分之一的前列腺癌患者有阳性家族史。在本报告中，我们评估了家族史与根治性前列腺切除术后长期预后之间的关联。
从德国一个登记处确定接受根治性前列腺切除术的患者，并分为一级家族史阳性组和家族史阴性组（严格阴性，要求至少有一名60岁以上的男性一级亲属且家族中无前列腺癌）。采用Kaplan-Meier曲线和Cox比例风险模型进行无生化复发生存和前列腺癌特异性生存的关联分析。
纳入研究的7690名男性的中位随访时间为8.4年。在754名年龄小于55岁的较年轻患者中，50.9%（384名）有家族史，而年龄较大患者（2803名）中这一比例为40.4%（p<0.001）。有家族史与无家族史的患者之间，以及较年轻与较年长患者组之间，10年无生化复发率（62.5%）和前列腺癌特异性生存率（96.1%）均无差异（所有p>0.05）。前列腺特异性抗原、病理分期、淋巴结分期和Gleason评分是无生化复发生存的唯一显著预测因素，而病理分期、淋巴结分期（所有p<0.005）和Gleason评分（Gleason 7分与6分及以下相比-HR 1.711，95%CI 1.056-2.774，p=0.03；Gleason 8分及以上与6分及以下相比-HR 4.516，95%CI 2.776-7.347，p<0.0001）是前列腺癌特异性生存的唯一预测因素。
前列腺癌家族史与根治性前列腺切除术后的长期预后无关。
