No detrimental effect of a positive family history on postoperative upgrading and upstaging in men with low risk and favourable intermediate-risk prostate cancer: implications for active surveillance

Purpose!#!To assess whether a first-degree family history or a fatal family history of prostate cancer (PCa) are associated with postoperative upgrading and upstaging among men with low risk and favourable intermediate-risk (FIR) PCa and to provide guidance on clinical decision making for active surveillance (AS) in this patient population.!##!Methods!#!Participants in the German Familial Prostate Cancer database diagnosed from 1994 to 2019 with (1) low risk (clinical T1c-T2a, biopsy Gleason Grade Group (GGG) 1, PSA < 10 ng/ml), (2) Gleason 6 FIR (clinical T1c-T2a, GGG 1, PSA 10-20 ng/ml), and (3) Gleason 3 + 4 FIR (clinical T1c-T2a, GGG 2, PSA < 10 ng/ml) PCa who were subsequently treated with radical prostatectomy (RP) were analysed for upgrading, defined as postoperative GGG 3 tumour or upstaging, defined as pT3-pT4 or pN1 disease at RP. Logistic regression analysis was used to assess whether PCa family history was associated with postoperative upgrading or upstaging.!##!Results!#!Among 4091 men who underwent RP, mean age at surgery was 64.4 (SD 6.7) years, 24.7% reported a family history, and 3.4% a fatal family history. Neither family history nor fatal family history were associated with upgrading or upstaging at low risk, Gleason 6 FIR, and Gleason 3 + 4 FIR PCa patients.!##!Conclusion!#!Results from the current study indicated no detrimental effect of family history on postoperative upgrading or upstaging. Therefore, a positive family history or fatal family history of PCa in FIR PCa patients should not be a reason to refrain from AS in men otherwise suitable

The preservation of fossil biomarkers during meteorite impact events: experimental evidence from biomarker-rich projectiles and target rocks

A Devonian siltstone from Orkney, Scotland, shows survival of biomarkers in high-velocity impact experiments. The biomarkers were detected in ejecta fragments from experiments involving normal incidence of steel projectiles at 5–6 km s−1, and in projectile fragments from impact experiments into sand and water at 2–5 km s−1. The associated peak shock pressures were calculated to be in the range of 110–147 GPa for impacts of the steel projectiles into the siltstone target, and hydrocode simulations are used to show the variation of peak pressure with depth in the target and throughout the finite volume projectiles. Thermally sensitive biomarker ratios, including ratios of hopanoids and steranes, and the methylphenanthrene ratio, showed an increase in thermal maturity in the ejecta, and especially the projectile, fragments. Measurement of absolute concentrations of selected biomarkers indicates that changes in biomarker ratios reflect synthesis of new material rather than selective destruction. Their presence in ejecta and projectile fragments suggests that fossil biomarkers may survive hypervelocity impacts, and that experiments using biomarker-rich rock have high potential for testing survival of organic matter in a range of impact scenarios