Abstract

Purpose

To determine whether fatal family history (FFH) or mode of inheritance in prostate cancer (PCa) has an impact on long-term outcomes following radical prostatectomy (RP).

Methods

1076 PCa patients after RP with at least one deceased first-degree relative with PCa were included and stratified by FFH (four subgroups: fraternal, paternal, multiple, and none) and by mode of inheritance (two subgroups: male to male, non-male to male). We compared clinicopathological characteristics between subgroups with Fisher’s exact or Chi-square tests. Biochemical recurrence-free survival (BRFS) and cancer-specific survival (CSS) were analyzed using the method of Kaplan and Meier. Simple and multiple Cox regression with backward elimination were performed to select prognostic factors for BRFS and CSS.

Results

Median age at surgery was 63.3 (range 35.9–79.4) years. The overall Kaplan–Meier estimated BRFS rate at 10 and 15 years was 65.6% and 57.0%, respectively. The overall Kaplan–Meier estimated CSS rate at 10 and 15 years was 98.1% and 95.7%, respectively. Neither FFH nor mode of inheritance were factors associated with worse BRFS. However, in multiple Cox regression, paternal FFH was an important prognostic factor for a better CSS (HR 0.19, CI 0.05–0.71, p = 0.014) compared to non-FFH.

Conclusion

FFH and mode of inheritance do not seem to be prognostic factors of worse long-term outcomes following RP. Rather, a paternal FFH was associated with a better CSS; however, the reasons remain unclear. Nevertheless, patients after RP and FFH could be reassured that their own PCa diagnosis is not associated with a worse long-term outcome.

中文翻译：

---

致命家族史和遗传模式在前列腺癌根治性前列腺切除术后长期结果中的作用

摘要

目的

确定致命的家族史（FFH）或前列腺癌的遗传方式（PCa）是否对根治性前列腺切除术（RP）后的长期结局产生影响。

方法

纳入RP后至少有一个一级亲属过世的1076例PCa患者，并按FFH（四个亚组：兄弟，父亲，多重和无）和遗传方式（两个亚组：男性至男性，非男对男）。我们用Fisher精确检验或卡方检验比较了亚组之间的临床病理特征。使用Kaplan和Meier的方法分析了无生化复发生存期（BRFS）和癌症特异性生存期（CSS）。进行简单和多次Cox回归分析并向后消除，以选择BRFS和CSS的预后因素。

结果

手术中位年龄为63.3岁（范围35.9-79.4）岁。Kaplan-Meier估计的10年和15年BRFS总体发生率分别为65.6％和57.0％。Kaplan–Meier估计的10年和15年CSS总体发生率分别为98.1％和95.7％。FFH和遗传方式都不是与更差的BRFS相关的因素。然而，在多次Cox回归中， 与非FFH相比，父亲FFH是获得更好CSS（HR 0.19，CI 0.05–0.71，p = 0.014）的重要预后因素。

结论

FFH和遗传模式似乎不是RP术后长期预后恶化的预后因素。相反，一个父系的FFH与更好的CSS相关联。但是，原因尚不清楚。然而，RP和FFH后的患者可以放心，他们自己的PCa诊断与长期预后不良无关。