Ethiopian Review

PORT DOUGLAS, AUSTRALIA (UroToday.com) – To determine the significance of BRCA2 mutation in men with prostate cancer in families affected by breast cancer vs. non-BRCA2 patients with prostate cancer from such families with a history of breast cancer.

METHODS
From a database of 11,000 families with breast and ovarian cancers, more than 150 patients with prostate cancer were identified. Mutation status was verified using the MLPA technique from blood and tissue samples. To demonstrate the contrast between survival rates and outcome, we used patients who were found to be negative for both BRCA1 and BRCA2 mutations, and these patients were defined as the control group, BRCAx. Only verified prostate cancer related deaths were included. The total duration of follow-up was 21 years (1981 – 2008). Patients were stratified to low, medium and high risk groups using the D’Amico classification.

RESULTS
To date we have genotyped 27 BRCA2 vs. 50 BRCAx patients in the study. The mean age at diagnosis for each group was 64.3 vs. 66.3 years respectively. The youngest patient in the BRCA2 group was diagnosed at 43 years old. The mean ages at deaths were 72.3 vs. 79.2 years (p=0.06). There were 13 prostate cancer specific deaths in the BRCA2 group compared to 6 in the BRCAx group. The mean duration from diagnosis to death was substantially less in BRCA2 vs. the BRCAx group (p= 0.036). Using D’Amico risk stratification, the majority in the BRCA2 group were high risk (70%). In terms of treatment, there were 16 BRCA2 (59%) patients who had definitive treatment compared to 32 (64%) BRCAx patients. Definitive treatment was defined as either surgery or radiotherapy. The differences in 10-year survival between BRCA2 and BRCAx cohorts using Kaplan-Meier analysis were highly significant ( p = 0.00087; Hazard Ratio=0.147). When BRCA2 patients were each delineated according to risk stratification, the high risk group only had a 20% probability of survival over 10 years.

CONCLUSIONS
Our initial results have demonstrated that patients who carry the BRCA2 mutation will more often have a high risk subtype of prostate cancer, with a higher mortality rate than those patients who do not carry the BRCA2 genotype.

- Uro Today