Introduction
Materials and methods
Database and study population
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(fraternal) fFFH: brother died of PCa
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(paternal) pFFH: father died of PCa
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(multiple) mFFH: at least two first-degree relatives died of PCa
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(none) nFFH: deceased first-degree relative(s) died of something other than PCa
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male to male (MTM): paternal mode of inheritance (father affected)
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non-male to male (nMTM): maternal mode of inheritance (only brothers affected)
Statistical analysis
Characteristics | Total | Stratified by FFH | Stratified by mode of inheritance | ||||||
---|---|---|---|---|---|---|---|---|---|
fFFH | pFFH | mFFH | nFFH | p value* | MTM | nMTM | p value* | ||
Hereditary PCa | < 0.001 | 0.951 | |||||||
Yes, n (%) | 412 (38.3) | 58 (40.9) | 109 (31.4) | 39 (100.0) | 208 (37.9) | 322 (61.8) | 90 (61.5) | ||
No, n (%) | 664 (61.7) | 84 (59.1) | 238 (68.6) | 0 (0.0) | 340 (62.1) | 520 (38.2) | 144 (38.5) | ||
Age at surgery (years) | 0.003 | < 0.001 | |||||||
Median (range) | 63.3 (35.9–79.4) | 64.8 (50.5–79.4) | 63.1 (35.9–77.6) | 64.3 (50.1–73.9) | 62.8 (40.6–77.3) | 62.9 (35.9–77.6) | 64.7 (47.8–79.4) | ||
≤ 55, n (%) | 137 (12.7) | 12 (8.5) | 56 (16.2) | 2 (5.1) | 67 (12.2) | 125 (14.9) | 12 (5.1) | ||
> 55 to ≤ 65, n (%) | 531 (49.4) | 63 (44.4) | 170 (45.0) | 19 (48.7) | 279 (50.9) | 421 (50.0) | 110 (47.0) | ||
> 65 to ≤ 75, n (%) | 389 (36.1) | 59 (41.5) | 116 (33.4) | 18 (46.2) | 59 (35.8) | 283 (33.6) | 106 (45.3) | ||
> 75, n (%) | 19 (1.8) | 8 (5.6) | 5 (1.4) | 0 (0) | 6 (1.1) | 13 (1.5) | 6 (2.6) | ||
PSA at diagnosis (ng/ml) | 0.168 | 0.050 | |||||||
Median (range) | 7.6 (0.8–222.5) | 9.1 (1.71–50.0) | 7.3 (1.2–107.0) | 9.22 (1.2–65.6) | 7.4 (0.8–222.5) | 7.4 (0.9–222.5) | 8.3 (0.8–50.0) | ||
≤ 4, n (%) | 96 (9.9) | 13 (10.3) | 35 (11.0) | 3 (9.1) | 45 (9.2) | 75 (9.8) | 21 (10.3) | ||
> 4 to ≤ 10, n (%) | 548 (56.6) | 61 (48.0) | 190 (59.7) | 18 (54.5) | 279 (56.8) | 449 (58.6) | 99 (48.8) | ||
> 10 to ≤ 20, n (%) | 224 (23.1) | 38 (29.9) | 68 (21.4) | 5 (15.2) | 113 (23.0) | 170 (22.2) | 54 (26.6) | ||
> 20, n (%) | 101 (10.4) | 15 (11.8) | 25 (7.9) | 7 (21.2) | 54 (11.0) | 72 (9.4) | 29 (14.3) | ||
Pathological tumor stage | 0.279 | 0.528 | |||||||
pT2, n (%) | 714 (67.5) | 89 (63.6) | 234 (68.8) | 21 (55.3) | 370 (68.5) | 565 (68.4) | 149 (64.2) | ||
pT3a, n (%) | 206 (19.5) | 28 (20.0) | 57 (16.8) | 10 (26.3) | 111 (20.6) | 154 (18.6) | 52 (22.4) | ||
pT3b, n (%) | 120 (11.3) | 21 (15.0) | 43 (12.6) | 7 (18.4) | 49 (9.1) | 92 (11.1) | 28 (12.1) | ||
pT4, n (%) | 18 (1.7) | 2 (1.4) | 6 (1.8) | 0 (0.0) | 10 (1.8) | 15 (1.9) | 3 (1.3) | ||
Pathological node stage | 0.475 | 0.270 | |||||||
Nx, n (%) | 135 (12.6) | 18 (12.7) | 38 (11.0) | 5 (12.8) | 74 (13.5) | 111 (13.2) | 24 (10.3) | ||
pN0, n (%) | 872 (81.0) | 112 (78.9) | 293 (84.4) | 30 (76.9) | 437 (79.7) | 681 (80.9) | 191 (81.6) | ||
pN1, n (%) | 69 (6.4) | 12 (8.4) | 16 (4.6) | 4 (10.3) | 37 (6.8) | 50 (5.9) | 19 (8.1) | ||
Surgical margin | 0.940 | ||||||||
R0, n (%) | 419 (79.7) | 46 (80.7) | 148 (81.8) | 11 (78.6) | 214 (78.1) | 0.812 | 342 (79.7) | 77 (79.4) | |
R1, n (%) | 107 (20.3) | 11 (19.3) | 33 (18.2) | 3 (21.4) | 60 (21.9) | 87 (20.3) | 20 (20.6) | ||
Pathological Gleason score | 0.506 | ||||||||
≤ 6, n (%) | 447 (48.5) | 58 (47.9) | 149 (50.7) | 9 (29.0) | 231 (48.6) | 0.001 | 354 (48.9) | 93 (46.9) | |
7 (3 + 4), n (%) | 65 (7.1) | 11 (9.1) | 17 (5.8) | 3 (9.7) | 34 (7.1) | 50 (9.9) | 15 (7.6) | ||
7, n (%) | 216 (23.4) | 21 (17.4) | 70 (23.8) | 6 (19.4) | 119 (25.0) | 166 (22.9) | 50 (25.2) | ||
7 (4 + 3), n (%) | 89 (9.6) | 15 (12.4) | 25 (8.5) | 11 (35.5) | 38 (8.0) | 66 (9.1) | 23 (11.6) | ||
8–10, n (%) | 105 (11.4) | 16 (13.2) | 33 (11.2) | 2 (6.4) | 54 (11.3) | 88 (12.2) | 17 (8.7) | ||
Adjuvant radiotherapy | 0.459 | 0.741 | |||||||
Yes, n (%) | 73 (8.8) | 8 (5.6) | 24 (6.9) | 5 (12.8) | 36 (6.6) | 56 (6.6) | 17 (7.3) | ||
No, n (%) | 1003 (93.2) | 134 (94.4) | 323 (93.1) | 34 (87.1) | 512 (93.4) | 786 (93.4) | 217 (92.7) | ||
Adjuvant hormone therapy | 0.001 | 0.005 | |||||||
Yes, n (%) | 105 (9.8) | 24 (16.9) | 27 (7.8) | 8 (20.5) | 46 (8.4) | 71 (8.4) | 34 (14.5) | ||
No, n (%) | 971 (90.2) | 118 (83.1) | 320 (92.2) | 31 (79.5) | 502 (91.6) | 771 (91.6) | 200 (85.5) |
Results
Patient characteristics
Fatal family history
Factors | BRFS | CSS | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Simple Cox regression | Multiple Cox regression | Simple Cox regression | Multiple Cox regression | |||||||||
HR | 95% CI | p value | HR | 95% CI | p value | HR | 95% CI | p value | HR | 95% CI | p value | |
Hereditary PCa | 0.023 | 0.131 | ||||||||||
(Ref.: no) | ||||||||||||
Yes | 1.26 | [1.03; 1.55] | 1.71 | [0.85; 3.42] | ||||||||
Mode of inheritance | 0.736 | 0.010 | ||||||||||
(Ref.: MTM) | ||||||||||||
nMTM | 1.04 | [0.82; 1.32] | 2.50 | [1.24; 5.04] | ||||||||
Fatal family history of PCa | 0.484 | 0.107 | 0.014 | |||||||||
(Ref.: nFFH) | ||||||||||||
fFFH | 1.19 | [0.89; 1.58] | 1.58 | [0.67; 3.71] | 0.41 | [0.12; 1.46] | ||||||
pFFH | 0.93 | [0.74; 1.16] | 0.53 | [0.19; 1.44] | 0.19 | [0.05; 0.71] | ||||||
mFFH | 0.96 | [0.55; 1.68] | 2.62 | [0.76; 9.01] | 2.45 | [0.68; 8.80] | ||||||
Age at surgery | 0.073 | 0.115 | ||||||||||
Continuous | 1.02 | [1.00; 1.03] | 1.05 | [0.99; 1.12] | ||||||||
PSA at diagnosis (ng/mL) | < 0.001 | < 0.001 | 0.111 | |||||||||
Continuous | 1.02 | [1.01; 1.02] | 1.03 | [1.02; 1.04] | 1.02 | [1.00; 1.04] | ||||||
Pathological tumor stage | < 0.001 | 0.028 | 0.001 | 0.011 | ||||||||
(Ref.: pT2) | ||||||||||||
≥ pT3a | 2.44 | [1.99; 2.98] | 1.58 | [1.05; 2.36] | 3.36 | [1.61; 6.99] | 3.54 | [1.34; 9.40] | ||||
Pathological node stage | < 0.001 | 0.002 | < 0.001 | < 0.001 | ||||||||
(Ref.: pN0/pNx) | ||||||||||||
pN1 | 2.18 | [1.58; 3.01] | 3.36 | [1.58; 7.15] | 4.80 | [2.15; 10.73] | 7.27 | [2.61; 20.27] | ||||
Surgical margin | < 0.001 | 0.005 | 0.050 | |||||||||
(Ref.: R0) | ||||||||||||
R1 | 2.12 | [1.52; 2.95] | 1.75 | [1.19; 2.59] | 4.95 | [1.00; 24.57] | ||||||
Pathological Gleason score | < 0.001 | < 0.001 | < 0.001 | |||||||||
(Ref.: ≤ 6) | ||||||||||||
7 | 2.02 | [1.34; 3.06] | 1.84 | [0.98; 3.45] | 1.16 | [0.15; 9.28] | ||||||
7 (3 + 4) | 1.67 | [1.24; 2.25] | 1.64 | [1.04; 2.57] | 2.37 | [0.82; 6.86] | ||||||
7 (4 + 3) | 2.69 | [1.89; 3.82] | 1.44 | [0.71; 2.95] | 7.09 | [2.66; 18.89] | ||||||
8–10 | 4.09 | [3.03; 5.53] | 3.33 | [2.05; 5.40] | 5.64 | [2.04; 15.64] | ||||||
Adjuvant radiotherapy | 0.056 | 0.338 | ||||||||||
(Ref.: no) | ||||||||||||
Yes | 1.41 | [0.99; 2.01] | 1.79 | [0.54; 5.93] | ||||||||
Adjuvant hormone therapy | < 0.001 | 0.035 | 0.006 | |||||||||
(Ref.: no) | ||||||||||||
Yes | 1.62 | [1.22; 2.14] | 0.47 | [0.23; 0.95] | 2.91 | [1.35; 6.29] |