Abstract
Introduction
The present study evaluated the incidence and prognostic value of second primary cancers
in patients with prostate cancer (PCa) who had undergone radical prostatectomy (RP).
Materials and Methods
From 2003 to 2013, 1915 patients who had undergone RP were included in the present
analysis. We calculated the propensity scores of various clinicopathologic factors
and matched 298 patients with and without second primary cancers in a 1:1 ratio. To
assess the baseline variables, we compared the descriptive statistics between the
2 groups. The postoperative biochemical recurrence (BCR)-free survival rates were
calculated using the Kaplan-Meier method. Multivariate Cox regression analysis was
performed to identify the independent predictors of BCR after RP.
Results
Overall, 159 patients with PCa (8.3%) who had undergone RP were diagnosed with second
primary cancers. After adjusting the patient characteristics in the propensity score-matched
analysis, no variables were significantly different between the 2 groups with 149
with and 149 without other primary cancers. Moreover, the BCR-free survival rates
were not significantly associated with the incidence of a second primary malignancy
or the time to diagnosis. In the multivariate Cox regression model, serum prostate-specific
antigen (hazard ratio [HR], 1.04), extraprostatic extension (HR, 3.29), seminal vesicle
invasion (SVI; HR, 2.85), and surgical margin positivity (HR, 4.11) remained as independent
predictors for BCR. However, the presence of a second primary malignancy was not predictive
for BCR. In patients with a second primary cancer, multivariate analysis identified
SVI (HR, 10.38) and positive surgical margin (HR, 3.48) as significant predictors
for BCR.
Conclusions
Our results suggest that the presence of second primary malignancies might not affect
BCR in patients with PCa who undergo RP.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Clinical Genitourinary CancerAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The global burden of cancer 2013.JAMA Oncol. 2015; 1: 505-527
- Biology of prostate-specific antigen.J Clin Oncol. 2003; 21: 383-391
- Prostate cancer in elderly men.Rev Urol. 2008; 10: 111-119
- Cancer in the elderly.Trans Am Clin Climatol Assoc. 2006; 117: 147-155
- Cancer-related inflammation.Nature. 2008; 454: 436-444
- Cancer-related inflammation and treatment effectiveness.Lancet Oncol. 2014; 15: e493-e503
- Second primary tumors involving non-small cell lung cancer: prevalence and its influence on survival.Chest. 2005; 127: 1152-1158
- Metachronous malignancies in men with previous prostate cancer in Umbria, Italy, 1994-2003.Tumori. 2008; 94: 7-10
- Incidence of second primary cancers in North Portugal—a population-based study.J Cancer Surviv. 2016; 10: 142-152
- World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects.JAMA. 2013; 310: 2191-2194
- What does failure after surgery or radiation mean?.Eur Urol Suppl. 2008; 7: 410-415
- New Malignancies Among Cancer Survivors: SEER Cancer Registries, 1973-2000.(NIH publication no. 05–5302) National Cancer Institute, Bethesda, MD2006
- Multiple cancer prevalence: a growing challenge in long-term survivorship.Cancer Epidemiol Biomarkers Prev. 2007; 16: 566-571
- Prevalence of multiple malignancies in the Netherlands in 2007.Int J Cancer. 2011; 128: 1659-1667
- Primary cancers before and after prostate cancer diagnosis.Cancer. 2012; 118: 6207-6216
- Prognostic significance of synchronous and metachronous bilateral breast cancer.World J Surg. 2001; 25: 1117-1124
- Primary and second primary cancer in 649 patients with malignancies of the maxillofacial region.Anticancer Res. 2007; 27: 1805-1818
- Multiple tumours in survival estimates.Eur J Cancer. 2009; 45: 1080-1094
- Survival in second primary malignancies of patients with head and neck cancer.J Laryngol Otol. 2002; 116: 831-838
- Multiple neoplasms, single primaries, and patient survival.Cancer Manag Res. 2014; 6: 119-134
- Long-term risk of clinical progression after biochemical recurrence following radical prostatectomy: the impact of time from surgery to recurrence.Eur Urol. 2011; 59: 893-899
Article info
Publication history
Published online: March 10, 2016
Accepted:
March 2,
2016
Received in revised form:
February 27,
2016
Received:
October 16,
2015
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
