Family history in patients who would have been candidates for active surveillance

Can J Urol. 2021 Apr;28(2):10632-10637.

Abstract

INTRODUCTION It is unknown whether a family history of prostate cancer confers additional risk among men who are candidates for active surveillance (AS).

Materials and methods: 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.

Results: 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).

Conclusion: 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.

MeSH terms

  • Aged
  • Humans
  • Male
  • Medical History Taking*
  • Middle Aged
  • Patient Selection
  • Prospective Studies
  • Prostatic Neoplasms / surgery
  • Prostatic Neoplasms / therapy*
  • Watchful Waiting*