MP57-04: Association between family history and oncologic outcomes after radical prostatectomy for clinically nonmetastatic prostate cancer

Paweł Rajwa*, Fahad Quhal, Stephan Korn, Takafumi Yanagisawa, Tatsushi Kawada, Reza Sari Motlagh, Hadi Mostafaei, Ekaterina Laukhtina, Abdulmajeed Aydh, Frederik König, Maximilian Pallauf, Benjamin Pradere, Vienna, Austria, Peter Nyirády, Budapest, Hungary, Mohammad Abufaraj, Amman, Jordan, Alberto Briganti, Milan, Italy, Pierre Karakiewicz, Montreal, Canada, Ding-wei Ye, Shanghai, China, People's Republic of, Martin Haydter, Vienna, Austria, Piotr Chlosta, Krakow, Poland, Petr Glybochko, Dmitry Enikeev, Moscow, Russian Federation, Shahrokh Shariat, Vienna, Austria

Introduction: While family history (FHx) of prostate cancer (PCa) increases the risk of PCa, comparably less is known regarding the impact of FHx on pathological and oncological outcomes after radical prostatectomy (RP). Therefore, we aimed to analyze the predictive and prognostic value of PCa FHx in a large cohort of patients treated with RP for clinically nonmetastatic PCa.

Methods: We retrospectively reviewed our multicenter database comprising 6,041 nonmetastatic PCa patients treated with RP. Patients with a FHx of PCa in one or more first-degree relatives were considered as FHx positive. Logistic regression and Cox regression analyses were performed to examine the association of FHx with pathologic results and biochemical recurrence (BCR), respectively. The area under the curve (AUC) derived from the receiver operating (ROC) curve and concordance-indices (C-Index) were used to explore the discriminatory ability of the models.

Results: In total 1,677 (28%) patients reported positive FHx. Men with positive FHx, compared to patients with negative FHx, were younger at RP with median age of 59 (interquartile range [IQR] 55-65) years vs. 62 (IQR 58-67) years (p < 0.01), respectively. Furthermore, patients with positive FHx had significantly more favorable biopsy and RP histopathological findings. On multivariable logistic regression analysis, positive FHx was an independent factor for extracapsular extension (odds ratio [OR] 0.77, 95% confidence interval [CI] 0.66-0.90, p<0.01; model AUC 0.73) and upgrading (OR 0.70, 95% CI 0.62-0.80, p<0.01; model AUC 0.68). For upgrading, but not for extracapsular extension, incorporating FHx significantly improved the AUC of the baseline model (p < 0.01).  Positive FHx was not associated with BCR in the pre- and postoperative multivariable model (hazard ratio [HR] 0.88, 95% CI 0.74-1.04, p=0.14 and HR 1.03, 95% CI 0.87-1.22, p=0.73, respectively); c-indexes of Cox multivariable models were: 0.73 and 0.82, respectively.

Conclusions: Clinically nonmetastatic PCa patients with positive FHx underwent surgery at a younger age and had significantly more favorable pathological results. Furthermore, after controlling for baseline clinicopathological features positive FHx, was a predictive factor for pathological outcomes. Nevertheless, there was no association between FHx and BCR.

Source of Funding: none