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67th Annual Meeting Abstracts
The Impact a Family History of Prostate Cancer has on PSA Recurrence-free Survival in Obese Men.
Benjamin M Brucker, Matthew J Resnick, *Meredith Bergey, Daniel Canter, *Seema Sonnad, Alan J Wein, Keith N Van Arsdalen, *S Bruce Malkowicz
University of Pennsylvania, Philadelphia, PA
Introduction: Obesity has been suggested as a risk factor for PSA recurrence in men after radical prostatectomy (RP). However a family history (FH) of prostate cancer has been shown not to increase this risk. We examined a prospectively maintained RP database (1991-2005) to determine the impact of FH on PSA recurrence-free survival (PSARFS) in obese men.
Materials & Methods: 2113 patients were analysis. FH of prostate cancer was defined as >1 primary or secondary relative with prostate cancer. PSA recurrence was defined as a postoperative elevation in serum PSA >0.2 ng/ml. Chi-square, Fisher's exact and T-tests were used to compare variables. Multivariate regression analysis was preformed to determine variables impact of on PSARFS.
Results: The mean follow-up was 62.2 months. The mean age and pathological Gleason score were 59.6 years and 6.5 respectively. 63% of men had no FH of prostate cancer, 19.8% had one relative with prostate cancer and 4.9% had >2 relatives with prostate cancer. FH was not an independent predictor of PSARFS on multivariate analysis. However, when subgroup analysis was performed, FH was a negative predictor of PSARFS in obese men, but not in non-obese men (HR=1.47, 95% CI 1.07, 2.04; p=0.02 and HR=0.80, 95% CI 0.42-1.43; p=0.45, respectively).
Conclusions: A FH of prostate cancer does not impact PSARFS after RP in non-obese men, but it does have a negative impact in obese men. More work is needed to define the potential biological mechanism of this relationship. Studies on hereditary prostate cancer should consider analyzing BMI data.
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