Mike Wenzel1,2, Christoph Würnschimmel2,3, Luigi Nocera2,4, Claudia Collà Ruvolo2,5, Zhe Tian2, Fred Saad2, Alberto Briganti4, Derya Tilki3,6, Markus Graefen3, Frederik C Roos1, Philipp Mandel1, Felix K H Chun1, Pierre I Karakiewicz2. 1. Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany. 2. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada. 3. Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany. 4. Division of Experimental Oncology, Department of Urology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy. 5. Department of Neurosciences, Reproductive Sciences, and Odontostomatology, University of Naples Federico II, Naples, Italy. 6. Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Abstract
BACKGROUND: To test the effect of urological primary cancers (bladder, kidney, testis, upper tract, penile, urethral) on overall mortality (OM) after secondary prostate cancer (PCa). METHODS: Within the Surveillance, Epidemiology and End Results (SEER) database, patients with urological primary cancers and concomitant secondary PCa (diagnosed 2004-2016) were identified and were matched in 1:4 fashion with primary PCa controls. OM was compared between secondary and primary PCa patients and stratified according to primary urological cancer type, as well as to time interval between primary urological cancer versus secondary PCa diagnoses. RESULTS: We identified 5,987 patients with primary urological and secondary PCa (bladder, n = 3,287; kidney, n = 2,127; testis, n = 391; upper tract, n = 125; penile, n = 47; urethral, n = 10) versus 531,732 primary PCa patients. Except for small proportions of Gleason grade group and age at diagnosis, PCa characteristics between secondary and primary PCa were comparable. Conversely, proportions of secondary PCa patients which received radical prostatectomy were smaller (29.0 vs. 33.5%), while no local treatment rates were higher (34.2 vs. 26.3%). After 1:4 matching, secondary PCa patients exhibited worse OM than primary PCa patients, except for primary testis cancer. Here, no OM differences were recorded. Finally, subgroup analyses showed that the survival disadvantage of secondary PCa patients decreased with longer time interval since primary cancer diagnosis. CONCLUSIONS: After detailed matching for PCa characteristics, secondary PCa patients exhibit worse survival, except for testis cancer patients. The survival disadvantage is attenuated, when secondary PCa diagnosis is made after longer time interval, since primary urological cancer diagnosis.
BACKGROUND: To test the effect of urological primary cancers (bladder, kidney, testis, upper tract, penile, urethral) on overall mortality (OM) after secondary prostate cancer (PCa). METHODS: Within the Surveillance, Epidemiology and End Results (SEER) database, patients with urological primary cancers and concomitant secondary PCa (diagnosed 2004-2016) were identified and were matched in 1:4 fashion with primary PCa controls. OM was compared between secondary and primary PCa patients and stratified according to primary urological cancer type, as well as to time interval between primary urological cancer versus secondary PCa diagnoses. RESULTS: We identified 5,987 patients with primary urological and secondary PCa (bladder, n = 3,287; kidney, n = 2,127; testis, n = 391; upper tract, n = 125; penile, n = 47; urethral, n = 10) versus 531,732 primary PCa patients. Except for small proportions of Gleason grade group and age at diagnosis, PCa characteristics between secondary and primary PCa were comparable. Conversely, proportions of secondary PCa patients which received radical prostatectomy were smaller (29.0 vs. 33.5%), while no local treatment rates were higher (34.2 vs. 26.3%). After 1:4 matching, secondary PCa patients exhibited worse OM than primary PCa patients, except for primary testis cancer. Here, no OM differences were recorded. Finally, subgroup analyses showed that the survival disadvantage of secondary PCa patients decreased with longer time interval since primary cancer diagnosis. CONCLUSIONS: After detailed matching for PCa characteristics, secondary PCa patients exhibit worse survival, except for testis cancer patients. The survival disadvantage is attenuated, when secondary PCa diagnosis is made after longer time interval, since primary urological cancer diagnosis.
Authors: Mike Wenzel; Luigi Nocera; Christoph Würnschimmel; Claudia Collà Ruvolo; Zhe Tian; Fred Saad; Alberto Briganti; Derya Tilki; Markus Graefen; Andreas Becker; Frederik C Roos; Felix K H Chun; Pierre I Karakiewicz Journal: Front Oncol Date: 2021-10-06 Impact factor: 6.244
Authors: Mike Wenzel; Felix Preisser; Benedikt Hoeh; Maria N Welte; Clara Humke; Clarissa Wittler; Christoph Würnschimmel; Andreas Becker; Pierre I Karakiewicz; Felix K H Chun; Philipp Mandel; Luis A Kluth Journal: Front Surg Date: 2021-12-09