The prognostic value of family history among patients with urinary bladder cancer |
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| Authors: | Katja K. Aben J. Alfred Witjes Sita H. Vermeulen |
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| Affiliation: | 1. Department for Health Evidence, Radboud university medical center, Nijmegen, The Netherlands;2. Comprehensive Cancer Center the Netherlands, Utrecht, The Netherlands;3. Department of Urology, Radboud university medical center, Nijmegen, The Netherlands |
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| Abstract: | A history of urinary bladder cancer (UBC) in first‐degree relatives increases UBC risk by twofold. The influence of positive family history on UBC prognosis is unknown. Here, we investigated association of first‐degree UBC family history with clinicopathological characteristics and prognosis of UBC patients. Detailed clinical data of 1,465 non‐muscle‐invasive bladder cancer (NMIBC) and 250 muscle‐invasive or metastatic bladder cancer (MIBC) patients, diagnosed from 1995 to 2010, were collected through medical file review. Competing risk analyses were used to compare recurrence‐free survival (RFS) and progression‐free survival (PFS) of NMIBC patients according to self‐reported UBC family history. Overall survival in MIBC patients was estimated using Kaplan‐Meier analysis. The added value of family history in prediction of NMIBC prognosis was quantified with Harrell's concordance‐index. Hundred (6.8%) NMIBC and 14 (5.6%) MIBC patients reported UBC in first‐degree relatives. Positive family history was statistically significantly associated with smaller tumor size and non‐significantly with more favorable distribution of other tumor characteristics. In univariable analyses, positive family history correlated with longer RFS (p = 0.11) and PFS (p = 0.04). Hazard ratios for positive vs. negative family history after adjustment for clinicopathological characteristics were 0.75 (95% CI = 0.53–1.07) and 0.45 (95% CI = 0.18–1.12) for RFS and PFS, respectively. Five familial and 48 sporadic MIBC patients (Kaplan‐Meier 10‐year risk: 41% and 25%) died within 10 years. Family history did not improve the c‐index of prediction models. This study shows that a first‐degree family history of UBC is not clearly associated with NMIBC prognosis. Family history does not aid in prediction of NMIBC recurrence or progression. |
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| Keywords: | family history urinary bladder cancer clinicopathological characteristics prognosis clinical outcome |
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