Family History of Cancer as Potential Prognostic Factor in Stage III Colorectal Cancer: a Retrospective Monoinstitutional Study

Background and Aims: The prognostic role of family history of cancer (FHC) in resected colorectal cancer (CRC) is controversial. The aim of the current study was to evaluate its impact in a monoinstitutional series of stage III CRC patients. Methods: This single institution retrospective analysis is aimed at evaluating whether FHC affects overall survival (OS) and disease-free survival (DFS) in stage III CRC patients. Moreover, the role of both colorectal FHC (FHCRC, in patients with at least one relative with CRC) and FHC “burden” have been investigated; patients were classified according to FHC in FHC negative, FHC-low (one “familial cluster” among parents/children/grandparents, brothers/sisters, uncles/cousins), and FHC-high (at least two clusters of those above mentioned). Results: From October 2000 to March 2019, 112 consecutive stage III CRC patients have been evaluated. Median age was 67 years (range 24–89); male/female ratio was 64/48. Fifty-three (47.3%) patients were FHC-negative while 59 (52.7%) patients were FHC-positive, 18 (16.1%) of whom were FHCRC-positive. Thirty-three (29.5%) patients were FHC-low, and 10 (8.9%) were FHC-high. At a median follow-up of 41.9 months, no statistically significant differences in DFS were found. FHC-positive patients had a significantly longer OS than FHC-negative (HR = 0.32 [95% CI 0.12–0.84], p = 0.0210), and a significant trend towards improved OS according to the FHC burden was found (p = 0.0255). No statistically significant differences were found in DFS and OS according to FHCRC. Conclusion: In this retrospective analysis, FHC-positive stage III CRC patients had a significantly longer OS compared to FHC-negative. Moreover, this survival benefit seems to increase according to the FHC burden. Further prospective studies, with longer follow-up and larger sample size, are necessary to confirm FHC as prognostic factor in this setting.