SIGNIFICANCE OF FAMILIAL HISTORY OF PROSTATE-CANCER TO TRADITIONAL PROGNOSTIC VARIABLES, GENETIC BIOMARKERS, AND RECURRENCE AFTER RADICAL PROSTATECTOMY

Objectives. Prostate cancer (PCa) has a familial predisposition impart ing an increased risk of developing the disease in those with a family history. The pathologic characteristics are similar to sporadic cases ; however, the disease-free survival rates of hereditary PCa have rece ntly been disputed, with one major study suggesting that familial case s have higher recurrence rates. Our study seeks to support or refute t his association and to evaluate the genetic biomarkers p53, bcl-2, Ki- 67, and neovascularity between familial and sporadic disease. Methods. We retrospectively reviewed data of 573 patients who underwent radica l prostatectomy over an 11-year period. Of these, 474 patients had kno wn family history data. Univariable statistical analysis using the Pea rson chi-square test and Kaplan-Meier disease-free survival analysis w as performed to identify any correlation between the tested variables and family history. Smaller subsets of this cohort that had available archival material for immunohistochemical staining and family history data were analyzed in a similar manner. Results. The preoperative vari ables (prostate-specific antigen, prostatic acid phosphatase, clinical stage, highest biopsy Gleason sum, and glandular differentiation) and postoperative variables (stage, highest Gleason sum, and glandular di fferentiation) did not correlate with family history. Kaplan-Meier dis ease-free survival analysis revealed no differences between sporadic a nd familiar cases. The analysis of p53, bcl-2, Ki-67, and angiogenesis revealed that only increasing p53 expression and positive family hist ory of PCa approached significance (P = 0.057). Conclusions. Prognosti c variables routinely used in PCa and selected genetic biomarker immun ostaining abnormalities are not significantly different in men with an d without a family history of PCa. Disease-free survival after radical prostatectomy is also unaffected by family history.