BACKGROUND:In a large number of studies a positive family history is documented as one of the main risk factors for the development of prostate cancer. In a US population an association between early-onset prostate cancer among familial patients and a more differentiated tumour was shown. The aim of this study was to compare clinical parameters between sporadic and familial or hereditary patients with an age at diagnosis < or =55 years. MATERIAL AND METHODS:The clinical data of prostate cancer patients with an age at diagnosis < or =55 years and who were recruited between July 1999 and the end of June 2004 to the database "familial prostate cancer in Germany" were analysed. The following data were documented for all patients: PSA at diagnosis, histopathological stage, grading, Gleason score and progression-free survival. RESULTS:The clinical data of 685 patients could be completed: 222 (32.4%) had one first-degree relative with prostate cancer, 48 of whom (7.0%) were hereditary; 463 (67.6%) were sporadic. The median age at diagnosis in the hereditary patients was 51.6 (41-55) years, in the familial patients 51.1 (35-55) years and in the sporadic patients 52.0 (38-55) years. The median follow-up was 24 months in hereditary, 36 months in familial and 35 months in sporadic patients. An initial curative therapy with radical prostatectomy or radiotherapy/brachytherapy was planned in 657/685 (95.9%) of the patients. There were no clear differences regarding PSA at diagnosis, the postoperative parameters (organ-confined disease, lymph node involvement, Gleason score, grading) and the progression-free survival in sporadic and familial or hereditary patients. CONCLUSIONS:Patients with an age at diagnosis < or =55 years have a positive family history more often than all prostate cancer patients in Germany. No association could be shown between pathohistological stage or clinical course and a positive family history in patients with an age at diagnosis < or =55 years.

译文

背景:在大量研究中,家族史阳性被证明是前列腺癌发展的主要危险因素之一。在美国人群中,家族性患者中的早发性前列腺癌与分化程度更高的肿瘤之间存在关联。这项研究的目的是比较诊断年龄小于或等于55岁的散发性和家族性或遗传性患者的临床参数。
材料与方法:分析了1999年7月至2004年6月在数据库“德国家族性前列腺癌”中招募的,诊断年龄≤55岁的前列腺癌患者的临床资料。记录了所有患者的以下数据:诊断时的PSA,组织病理学阶段,分级,格里森评分和无进展生存期。
结果:685例患者的临床资料可以完成:222例(32.4%)一级前列腺癌患者,其中48例(7.0%)是遗传性的。 463例(67.6%)为散发性。遗传患者的诊断中位年龄为51.6(41-55)岁,家族患者为51.1(35-55)岁,散发患者为52.0(38-55)岁。中位随访时间为遗传性24个月,家族性36个月,散发性患者35个月。 657/685(95.9%)的患者计划采用根治性前列腺切除术或放射疗法/近距离放射疗法进行初步治疗。在散发性,家族性或遗传性患者中,PSA的诊断,术后参数(器官受限疾病,淋巴结受累,格里森评分,分级)和无进展生存期无明显差异。
结论:在德国,诊断年龄小于或等于55岁的患者具有阳性家族史的频率高于所有前列腺癌患者。在诊断年龄≤55岁的患者中,病理组织学阶段或临床病程与阳性家族史之间没有关联。

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