PD62-03 THE ASSOCIATION OF FAMILY HISTORY SUGGESTIVE OF HEREDITARY GERMLINE MUTATIONS WITH CLINICAL AND PATHOLOGICAL OUTCOMES IN PROSTATE CANCER PATIENTS ON ACTIVE SURVEILLANCE (2020)

You have accessJournal of UrologyProstate Cancer: Localized: Active Surveillance II (PD62)1 Apr 2020PD62-03 THE ASSOCIATION OF FAMILY HISTORY SUGGESTIVE OF HEREDITARY GERMLINE MUTATIONS WITH CLINICAL AND PATHOLOGICAL OUTCOMES IN PROSTATE CANCER PATIENTS ON ACTIVE SURVEILLANCE Ghalib Jibara*, Emily Vertosick, James Eastham, Vincent Laudone, Karim Touijer, Peter Scardino, Xin Lin, Maria Carlo, and Behfar Ehdaie Ghalib Jibara*Ghalib Jibara* More articles by this author , Emily VertosickEmily Vertosick More articles by this author , James EasthamJames Eastham More articles by this author , Vincent LaudoneVincent Laudone More articles by this author , Karim TouijerKarim Touijer More articles by this author , Peter ScardinoPeter Scardino More articles by this author , Xin LinXin Lin More articles by this author , Maria CarloMaria Carlo More articles by this author , and Behfar EhdaieBehfar Ehdaie More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000979.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Hereditary germline mutations (HGM) in prostate cancer (PCa) patients are associated with aggressive disease, with some mutations having therapeutic and prognostic implications. The role of these mutations in PCa patients on active surveillance (AS) is far less established than it is in more advanced disease. The objective of this study was to identify the prevalence of AS patients who have family history (FHx) suggestive of potential HGM and to examine the association of such history with risk of progression and adverse pathology (AP) in those who undergo radical prostatectomy (RP). METHODS: Between 2000-2019, all our AS patients were assessed for FHx of cancer by retrospectively reviewing our prospectively maintained database. FHx was defined as per NCCN PCa Guidelines v2.2019 criteria. A FHx of PCa was defined as at least one 1st-degree or two 2nd-degree relatives with PCa; FHx of potential HGM was defined as ≥ 3 relatives on one family side with: bile duct, breast, colorectal, endometrial, gastric, kidney, prostate, melanoma, ovarian, pancreatic, small bowel or urothelial cancer. Multivariable Cox and logistic regression models were created to assess the association between FH and time to progression and AP, respectively, adjusting for age, PSA and grade group at diagnosis. AP was defined as upgrading from final pre-RP biopsy, EPE, SVI or LNI. RESULTS: Among our cohort of 3211 patients, 666 patients (21%) had a FH of PCa, 35 patients (1.1%) had FH suggestive of HGM, and 94 patients (2.9%) had a FH of both. There were 752 patients who progressed on AS with a median follow up time for those without progression of 3.7 years. Of 482 patients who underwent RP, 214 had adverse pathology. While FHx of PCa was associated with increased risk of progression (HR 1.31, 95% CI 1.11, 1.55, p=0.002), we did not find evidence that FHx suggestive of HGM (HR 0.67, 95% CI 0.30, 1.50, p=0.3) or FHx of both (HR 1.23, 95% CI 0.81, 1.85, p=0.3) were associated with an increased risk. Similarly, we found no evidence that FH of PCa, HGM or both were associated with AP at RP (p=0.4). CONCLUSIONS: FHx suggestive of HGM is present in a smaller percentage of AS patients and it is not significantly associated with disease progression. Patients with low grade prostate cancer should not be counseled to seek immediate treatment based on FHx suggestive of HGM. Hereditary testing is needed to elucidate the actual percentage of these mutations in AS patients and their association with disease outcome. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1286-e1286 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ghalib Jibara* More articles by this author Emily Vertosick More articles by this author James Eastham More articles by this author Vincent Laudone More articles by this author Karim Touijer More articles by this author Peter Scardino More articles by this author Xin Lin More articles by this author Maria Carlo More articles by this author Behfar Ehdaie More articles by this author Expand All Advertisement PDF downloadLoading ...