Division of Urology, University of Pennsylvania Department of Surgery, Philadelphia, Pennsylvania, USA.
Can J Urol. 2021 Apr;28(2):10632-10637.
INTRODUCTION It is unknown whether a family history of prostate cancer confers additional risk among men who are candidates for active surveillance (AS).
Using a prospectively maintained database of men who underwent radical prostatectomy (RP) (2010- 2018), candidates for AS were identified according to the expanded criteria. Pathological upgrading was defined as a pathologic Gleason score (pGS) of 3+4 or higher for patients with a biopsy GS of 3+3 and a pGS of 4+3 or higher for patients with a biopsy GS of 3+4. Major upgrading was defined as a pGS of 4+4 or higher. The ₓ2 test was used for comparisons.
Of 1,320 men who were candidates for AS, 288 (21.8%) had a family history of prostate cancer. There were no differences in terms of the age, number of positive cores, or number of patients with a GS of 7 between the two groups. Pathological upgrading was observed in 61.1% of the total cohort, with no difference observed between the two groups (60.7% versus 62.5%; p = 0.5).
In men who are eligible for AS according to the expanded criteria, a family history of prostate cancer does not appear to be associated with adverse pathology at RP.
目前尚不清楚前列腺癌家族史是否会增加符合主动监测（AS）标准的男性的风险。
使用 2010 年至 2018 年接受根治性前列腺切除术（RP）的男性前瞻性维护数据库，根据扩展标准确定 AS 候选者。病理升级定义为活检 GS 为 3+3 的患者 pGS 为 3+4 或更高，活检 GS 为 3+4 的患者 pGS 为 4+3 或更高。主要升级定义为 pGS 为 4+4 或更高。采用 ₓ2 检验进行比较。
在 1320 名符合 AS 标准的男性中，有 288 名（21.8%）有前列腺癌家族史。两组在年龄、阳性核心数或 GS 为 7 的患者数方面无差异。在总队列中观察到 61.1%的患者出现病理升级，两组之间无差异（60.7%比 62.5%；p=0.5）。
在符合扩展标准的 AS 男性中，前列腺癌家族史似乎与 RP 不良病理无关。
