Felix Preisser1,2,3, Elio Mazzone2,4, Sophie Knipper1,2, Sebastiano Nazzani2,5, Marco Bandini2,4, Shahrokh F Shariat6, Michele Marchioni2,7, Zhe Tian2, Fred Saad2, Daniel Taussky8, Alberto Briganti4, Hartwig Huland1, Markus Graefen1, Derya Tilki1,9, Pierre I Karakiewicz2. 1. Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany. 2. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Centre, Montreal, QC, Canada. 3. Department of Urology, University Hospital Frankfurt, Frankfurt, Germany. 4. Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy. 5. Academic Department of Urology, IRCCS Policlinico San Donato, University of Milan, Milan, Italy. 6. Department of Urology, Medical University of Vienna, Vienna, Austria. 7. Department of Urology, SS Annunziata Hospital, "G.D'Annunzio" University of Chieti, Chieti, Italy. 8. Department of Radiation Oncology, University of Montreal Health Centre, Montreal, QC, Canada. 9. Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Abstract
INTRODUCTION: We aimed to investigate the effect of radiotherapy (RT) in contemporary patients treated with radical prostatectomy (RP) compared to RP alone for non-metastatic prostate cancer (PCa) on the incidence of second primary cancers (SPCs). METHODS: Within the Surveillance, Epidemiology, and End Results (SEER) database (2004-2015), we identified patients with PCa as the only or first primary cancer, who underwent RP and RT or RP alone. Cumulative incidence plots and multivariable Cox regression models tested for SPC rate differences according to treatment type: RP and RT vs. RP alone. Subgroup analyses focused on pelvic, primary pelvic, and non-pelvic SPCs, as well as on late SPCs (>5 years after PCa diagnosis). RESULTS: Of 152 161 patients, 7.1% (n=10 870) received RP and RT. Overall, 6.6 vs. 5.0% developed SPCs after RP and RT vs. RP alone, respectively (p<0.001). Cumulative incidence rates at 10 years after PCa diagnosis for RP and RT vs. RP were 12.0 vs. 8.7% (p<0.001), 2.0 vs. 1.2% (p<0.001), 2.1 vs. 1.3% (p<0.001), and 9.9 vs. 7.4% (p<0.001) for overall SPCs, primary pelvic SPCs, overall pelvic SPCs, and non-pelvic SPCs, respectively. Multivariable Cox regression models revealed an increased risk after RP and RT vs. RP alone for overall (hazard ratio [HR] 1.2; p<0.001), primary pelvic (HR 1.5; p<0.01), pelvic (HR1.4; p<0.001), non-pelvic (HR1.1; p<0.01), late overall (HR 1.2; p=0.01), and late non-pelvic SPCs (HR1.2; p=0.03). CONCLUSIONS: RP with RT was associated with moderately increased risk of SPCs compared to RP alone. This observation should be thoroughly discussed at informed consent and considered during followup.
INTRODUCTION: We aimed to investigate the effect of radiotherapy (RT) in contemporary patients treated with radical prostatectomy (RP) compared to RP alone for non-metastatic prostate cancer (PCa) on the incidence of second primary cancers (SPCs). METHODS: Within the Surveillance, Epidemiology, and End Results (SEER) database (2004-2015), we identified patients with PCa as the only or first primary cancer, who underwent RP and RT or RP alone. Cumulative incidence plots and multivariable Cox regression models tested for SPC rate differences according to treatment type: RP and RT vs. RP alone. Subgroup analyses focused on pelvic, primary pelvic, and non-pelvic SPCs, as well as on late SPCs (>5 years after PCa diagnosis). RESULTS: Of 152 161 patients, 7.1% (n=10 870) received RP and RT. Overall, 6.6 vs. 5.0% developed SPCs after RP and RT vs. RP alone, respectively (p<0.001). Cumulative incidence rates at 10 years after PCa diagnosis for RP and RT vs. RP were 12.0 vs. 8.7% (p<0.001), 2.0 vs. 1.2% (p<0.001), 2.1 vs. 1.3% (p<0.001), and 9.9 vs. 7.4% (p<0.001) for overall SPCs, primary pelvic SPCs, overall pelvic SPCs, and non-pelvic SPCs, respectively. Multivariable Cox regression models revealed an increased risk after RP and RT vs. RP alone for overall (hazard ratio [HR] 1.2; p<0.001), primary pelvic (HR 1.5; p<0.01), pelvic (HR1.4; p<0.001), non-pelvic (HR1.1; p<0.01), late overall (HR 1.2; p=0.01), and late non-pelvic SPCs (HR1.2; p=0.03). CONCLUSIONS: RP with RT was associated with moderately increased risk of SPCs compared to RP alone. This observation should be thoroughly discussed at informed consent and considered during followup.
Authors: Nicholas G Zaorsky; Amy S Harrison; Edouard J Trabulsi; Leonard G Gomella; Timothy N Showalter; Mark D Hurwitz; Adam P Dicker; Robert B Den Journal: Nat Rev Urol Date: 2013-09-10 Impact factor: 14.432
Authors: Felix Preisser; Marco Bandini; Elio Mazzone; Sebastiano Nazzani; Michele Marchioni; Zhe Tian; Fred Saad; Raisa S Pompe; Shahrokh F Shariat; Hans Heinzer; Francesco Montorsi; Hartwig Huland; Markus Graefen; Derya Tilki; Pierre I Karakiewicz Journal: Eur Urol Focus Date: 2018-05-22
Authors: Michele Marchioni; Marco Bandini; Raisa S Pompe; Zhe Tian; Tristan Martel; Anil Kapoor; Luca Cindolo; Francesco Berardinelli; Alberto Briganti; Shahrokh F Shariat; Luigi Schips; Pierre I Karakiewicz Journal: Int Urol Nephrol Date: 2017-09-20 Impact factor: 2.370
Authors: Ian M Thompson; Catherine M Tangen; Jorge Paradelo; M Scott Lucia; Gary Miller; Dean Troyer; Edward Messing; Jeffrey Forman; Joseph Chin; Gregory Swanson; Edith Canby-Hagino; E David Crawford Journal: JAMA Date: 2006-11-15 Impact factor: 56.272