Objective
To assess whether men with a family history of prostate cancer are more likely to
fail active surveillance because of recategorization of their tumors on subsequent
surveillance biopsies.
Methods
Men enrolled in an institutional review board–approved active surveillance program
were studied, and data on first- and/or second-degree family history of prostate cancer
was collected. Analyses were performed to compare the frequency of family history
with recategorization (higher grade or volume disease) on surveillance biopsies.
Results
Men with and without family history were recategorized with higher grade disease at
a similar frequency (30.9% vs 32.8%). There was no evidence that men with a family
history with higher grade disease had more aggressive pathology at the time of radical
prostatectomy than men without a family history. Although those with a family history
tended to have a shorter time period to recategorization with more positive cores,
the difference was not significant.
Conclusion
Our results suggest that men with a family history of prostate cancer are not at an
increased risk for recategorization on active surveillance. Men with a family history
of prostate cancer should not be deterred from considering active surveillance as
a treatment option.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to UrologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Cancer statistics, 2014.CA Cancer J Clin. 2014; 64: 9-29
- Active surveillance for prostate cancer: progress and promise.J Clin Oncol. 2011; 29: 3669-3676
- Active surveillance for prostate cancer: for whom?.J Clin Oncol. 2005; 23: 8165-8169
- National Institutes of Health State-of-the-Science Conference: role of active surveillance in the management of men with localized prostate cancer.Ann Intern Med. 2012; 156: 591-595
- Active surveillance in men with localized prostate cancer: a systematic review.Ann Intern Med. 2012; 156: 582-590
- The changing face of low-risk prostate cancer: trends in clinical presentation and primary management.J Clin Oncol. 2004; 22: 2141-2149
- The influence of family history on prostate cancer risk: implications for clinical management.BJU Int. 2011; 107: 716-721
- Relative risk of prostate cancer for men with affected relatives: systematic review and meta-analysis.Int J Cancer. 2003; 107: 797-803
- A systematic review and meta-analysis of familial prostate cancer risk.BJU Int. 2003; 91: 789-794
- Aggressiveness of familial prostate cancer.J Clin Oncol. 2006; 24: 3445-3450
- Should a family history of prostate cancer affect the total PSA or PSA velocity threshold for biopsy?.J Urol. 2008; 179 (Ref Type: Abstract): 714-715
- Lethality of prostate cancer in a primary relative does not appear to increase the risk of aggressive malignancy.J Urol. 2012; 187 (Ref Type: Abstract): e661
Carroll PR, Parsons JK, Andriole G, et al. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) Prostate Cancer Early Detection Version 1.2014. 2014 National Comprehensive Cancer Network, Inc. Available at www.NCCN.org. Accessed: January 29, 2015.
- Clinical implications of family history of prostate cancer and genetic risk single nucleotide polymorphism (SNP) profiles in an active surveillance cohort.BJU Int. 2013; 112: 666-673
Mohler JL, Armstrong AJ, Bahnson RR, et al. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) Prostate Cancer Version 1.2015. 2014 National Comprehensive Cancer Network, Inc. Available at www.NCCN.org. Accessed: January 29, 2015.
- Does family history of prostate cancer affect outcomes following radiotherapy?.Radiother Oncol. 2014; 110: 229-234
- Impact of family history on prostate cancer mortality in Caucasian men undergoing PSA-based screening.J Urol. 2014; 193: 75-79
Article info
Publication history
Published online: February 21, 2015
Accepted:
October 21,
2014
Received:
July 7,
2014
Footnotes
Financial Disclosure: The authors declare that they have no relevant financial interests.
Funding Support: This study was supported by the John and Carol Walter Center for Urological Health, NorthShore University HealthSystem.
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Editorial CommentUrologyVol. 85Issue 4
- PreviewAlthough there is clear evidence that positive family history (FH) is a well-known risk factor for the development of prostate cancer (PCa), there are conflicting data whether PCa in these patients has a worse oncologic outcome. If so, directly curative treatment options instead of active surveillance strategies might be the better option.
- Full-Text
- Preview
