Impact of a family history of prostate cancer on clinicopathologic outcomes and survival following radical prostatectomy

While a family history (FH) of prostate cancer represents an established risk factor for prostate cancer diagnosis, conflicting data exist regarding the oncologic importance of FH. Herein, we evaluated the association of FH with clinicopathologic outcomes among men undergoing radical prostatectomy (RP). We identified 16,472 men who underwent RP between 1987 and 2010 at Mayo Clinic. Patients were considered to have a positive FH if at least one first-degree relative had been diagnosed with prostate cancer. Survival was estimated using the Kaplan-Meier method. The associations of FH with clinicopathologic features and survival were evaluated using logistic and Cox regression analyses. Overall, 5323 (32.3 %) men reported a FH of prostate cancer. Median follow-up was 9.9 years (IQR 5.9, 15.5). Patients with a FH were significantly more likely to have low-risk disease (47.7 vs. 43.0 %; p < 0.0001) and were significantly more likely to have organ-confined disease at RP (79.2 vs. 74.4 %; p < 0.0001). Men with FH had a significantly higher 10-year cancer-specific (99 vs. 97 %; p < 0.001) and overall survival (92 vs. 85 %; p < 0.001) than men without FH. Moreover, on multivariable analysis, FH of prostate cancer remained independently associated with reduced cancer-specific (HR 0.68; p = 0.003) and all-cause mortality (HR 0.69; p < 0.0001). In this surgical population, FH of prostate cancer was associated with lower-risk disease at diagnosis, more favorable pathology at RP, and significantly better cancer-specific and overall survival. These results may be utilized for patient counseling.