No detrimental effect of a positive family history on postoperative upgrading and upstaging in men with low risk and fav
- PDF / 496,469 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 98 Downloads / 137 Views
ORIGINAL ARTICLE
No detrimental effect of a positive family history on postoperative upgrading and upstaging in men with low risk and favourable intermediate‑risk prostate cancer: implications for active surveillance Kathleen Herkommer1 · Nikola Maier1 · Donna P. Ankerst2 · Stefan Schiele1 · Jürgen E. Gschwend1 · Valentin H. Meissner1 Received: 8 August 2020 / Accepted: 3 October 2020 © The Author(s) 2020
Abstract Purpose To assess whether a first-degree family history or a fatal family history of prostate cancer (PCa) are associated with postoperative upgrading and upstaging among men with low risk and favourable intermediate-risk (FIR) PCa and to provide guidance on clinical decision making for active surveillance (AS) in this patient population. Methods Participants in the German Familial Prostate Cancer database diagnosed from 1994 to 2019 with (1) low risk (clinical T1c–T2a, biopsy Gleason Grade Group (GGG) 1, PSA 10 to ≤ 20, n (%) DRE, n (%) Non-suspicious Suspicious Pathological tumour stage, n (%) ≤ pT2c pT3a pT3b
Table 1 (continued) 2607 (63.7) 630 (15.4) 854 (20.9) 183 (7.2) 2356 (92.8) 67 (10.6) 563 (89.4) 118 (13.8) 736 (86.2) 313 (12.0) 2294 (88.0) 152 (24.1) 478 (75.9) 142 (16.6) 712 (83.4) 64.1 (6.6) 389 (9.5) 1741 (42.6) 1961 (47.9) 3934 (74.7) 748 (18.3) 286 (7.0) 3934 (96.2) 157 (3.8) 2063 (50.4) 2027 (49.6) 3565 (87.1) 139 (3.4) 387 (9.5) 7.0 (3.3) 475 (11.6) 3010 (73.6) 606 (14.8) 3218 (78.7) 873 (21.3) 3509 (85.8) 437 (10.7) 124 (3.0)
pT4 Pathological node stage, n (%) pN0 pN1 Surgical margin, n (%) R0 R1 Pathological Gleason Grade Group, n (%) 1 2/3 2 3 4 Adjuvant radiotherapy, n (%) Yes No Adjuvant hormone therapy, n (%) Yes No
21 (0.5) 4025 (98.5) 61 (1.5) 2651 (88.7) 339 (11.3) 2326 (58.6) 120 (3.0) 1205 (30.4) 220 (5.5) 97 (2.5) 158 (3.9) 3933 (96.1) 107 (2.6) 3984 (97.4)
PCa prostate cancer, SD standard deviation, FIR favourable intermediate risk, PSA prostate-specific antigen, DRE digital rectal examination *Upgrading was defined as postoperative Gleason Grade Group 3 tumour in radical prostatectomy **Upstaging was defined as pT3–pT4 or pN1 disease at radical prostatectomy
age (OR 1.06, 95% CI 1.03–1.08) and higher PSA at diagnosis (OR 1.14, 95% CI 1.05–1.23) were associated with postoperative upgrading. Secondary non-urologic cancers (OR 0.52, 95% CI 0.28–0.97) were associated with a lower risk of upgrading. Higher PSA at diagnosis (1.18, 95% CI 1.11–1.26) was the only factor associated with postoperative upstaging.
Predictors of upgrading and upstaging in men with FIR PCa In single logistic regression analyses, neither family history nor fatal family history were associated with upgrading and upstaging in men with Gleason 6 FIR and Gleason 3 + 4 FIR PCa (Tables 3, 4). In multiple regression analyses, higher PSA level at diagnosis (1.14, 95% CI 1.03–1.26) and suspicious DRE (1.73, 95% CI 1.08–2.78) were associated with upgrading among Gleason 3 + 4 FIR PCa patients. Higher PSA level at diagnosis (1.16, 95% CI 1.05–1.27) was associated with an increased ri
Data Loading...
