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Jahreiß MC, Heemsbergen WD, Aben KKH, Incrocci L. Risk factors for secondary bladder cancer following prostate cancer radiotherapy. Transl Androl Urol 2024; 13:1288-1296. [PMID: 39100827 PMCID: PMC11291406 DOI: 10.21037/tau-23-667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 05/05/2024] [Indexed: 08/06/2024] Open
Abstract
This review investigates the complex landscape of secondary bladder cancer (SBC) after radiotherapy for prostate cancer (PCa). External beam radiotherapy (EBRT) poses an increased risk for SBC, while brachytherapy seems to be associated with smaller increased risks for SBC due to its targeted radiation delivery, sparing the surrounding bladder tissue. Secondary cancers in the bladder are the most frequently diagnosed secondary cancers in the PCa patient population treated with radiotherapy. Patient-related factors are pivotal, with age emerging as a dual-edged factor. While advanced age is a recognized risk for bladder cancer, younger PCa patients exhibit higher susceptibility to radiation-induced cancers. Smoking, a well-established bladder cancer risk factor, increases this vulnerability. Studies highlight the synergistic effect of smoking and radiation exposure, amplifying the likelihood of genetic mutations and SBC. The latency period of SBC, which spans years to decades, remains a critical aspect. There is a strong dose-response relationship between radiation exposure and SBC risk, with higher doses consistently being associated with a higher SBC risk. While specific models for therapeutic radiation-induced SBC are lacking, insights from related studies, like the Atomic Bomb survivor research, emphasize the bladder's sensitivity to radiation-induced cancer. Chemotherapy in combination with radiotherapy, although infrequently used in PCa, emerges as a potential risk for bladder cancer. Bladder cancer's complex epidemiology, encompassing risk factors, treatment modalities, and cancer types, provides a comprehensive backdrop. As research refines understanding, we hope that this review contributes to guide clinicians, inform patient care, and shape preventive strategies on SBC.
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Affiliation(s)
- Marie-Christina Jahreiß
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Wilma D. Heemsbergen
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Katja K. H. Aben
- Department of Research, Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands
- Deaprtment for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Luca Incrocci
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
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2
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Boué-Raflé A, Briens A, Supiot S, Blanchard P, Baty M, Lafond C, Masson I, Créhange G, Cosset JM, Pasquier D, de Crevoisier R. [Does radiation therapy for prostate cancer increase the risk of second cancers?]. Cancer Radiother 2024; 28:293-307. [PMID: 38876938 DOI: 10.1016/j.canrad.2023.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/14/2023] [Accepted: 07/16/2023] [Indexed: 06/16/2024]
Abstract
PURPOSE The increased risk of second cancer after prostate radiotherapy is a debated clinical concern. The objective of the study was to assess the risk of occurrence of second cancers after prostate radiation therapy based on the analysis the literature, and to identify potential factors explaining the discrepancies in results between studies. MATERIALS AND METHODS A review of the literature was carried out, comparing the occurrence of second cancers in patients all presenting with prostate cancer, treated or not by radiation. RESULTS This review included 30 studies reporting the occurrence of second cancers in 2,112,000 patients treated or monitored for localized prostate cancer, including 1,111,000 by external radiation therapy and 103,000 by brachytherapy. Regarding external radiation therapy, the average follow-up was 7.3years. The majority of studies (80%) involving external radiation therapy, compared to no external radiation therapy, showed an increased risk of second cancers with a hazard ratio ranging from 1.13 to 4.9, depending on the duration of the follow-up. The median time to the occurrence of these second cancers after external radiotherapy ranged from 4 to 6years. An increased risk of second rectal and bladder cancer was observed in 52% and 85% of the studies, respectively. Considering a censoring period of more than 10 years after irradiation, 57% and 100% of the studies found an increased risk of rectal and bladder cancer, without any impact in overall survival. Studies of brachytherapy did not show an increased risk of second cancer. However, these comparative studies, most often old and retrospective, had many methodological biases. CONCLUSION Despite numerous methodological biases, prostate external radiation therapy appears associated with a moderate increase in the risk of second pelvic cancer, in particular bladder cancer, without impacting survival. Brachytherapy does not increase the risk of a second cancer.
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Affiliation(s)
- A Boué-Raflé
- Département de radiothérapie, centre Eugène-Marquis, 3, avenue de la Bataille-Flandres-Dunkerque, Rennes, France.
| | - A Briens
- Département de radiothérapie, centre Eugène-Marquis, 3, avenue de la Bataille-Flandres-Dunkerque, Rennes, France
| | - S Supiot
- Département de radiothérapie, Institut de cancérologie de l'Ouest, centre René-Gauducheau, boulevard Jacques-Monod, Saint-Herblain, France; Centre de recherche en cancérologie Nantes-Angers (CRCNA), UMR 1232, Inserm - 6299, CNRS, institut de recherche en santé de l'université de Nantes, Nantes cedex, France
| | - P Blanchard
- Département de radiothérapie oncologique, Gustave-Roussy, Villejuif, France; Oncostat U1018, Inserm, université Paris-Saclay, Villejuif, France
| | - M Baty
- Département de radiothérapie, centre Eugène-Marquis, 3, avenue de la Bataille-Flandres-Dunkerque, Rennes, France
| | - C Lafond
- Département de radiothérapie, centre Eugène-Marquis, 3, avenue de la Bataille-Flandres-Dunkerque, Rennes, France; Laboratoire Traitement du signal et de l'image (LTSI), U1099, Inserm, Rennes, France
| | - I Masson
- Département de radiothérapie, centre Eugène-Marquis, 3, avenue de la Bataille-Flandres-Dunkerque, Rennes, France
| | - G Créhange
- Département de radiothérapie, institut Curie, 25, rue d'Ulm, Paris, France; Département d'oncologie radiothérapie, centre de protonthérapie, institut Curie, Orsay, France; Département d'oncologie radiothérapie, institut Curie, 92, boulevard Dailly, Saint-Cloud, France; Laboratoire d'imagerie translationnelle en oncologie (Lito), U1288, Inserm, institut Curie, université Paris-Saclay, Orsay, France
| | - J-M Cosset
- Groupe Amethyst, centre de radiothérapie Charlebourg, 92250 La Garenne-Colombes, France
| | - D Pasquier
- Département de radiothérapie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, Lille, France; CNRS, CRIStAL UMR 9189, université de Lille, Lille, France
| | - R de Crevoisier
- Département de radiothérapie, centre Eugène-Marquis, 3, avenue de la Bataille-Flandres-Dunkerque, Rennes, France; Laboratoire Traitement du signal et de l'image (LTSI), U1099, Inserm, Rennes, France
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3
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Tsai MH, Bevel MS, Andrzejak SE, Moore JX. Receipt of follow-up care plans on colorectal cancer screening among breast, prostate, and lung cancer survivors. J Cancer Surviv 2024; 18:781-790. [PMID: 36574189 PMCID: PMC10293471 DOI: 10.1007/s11764-022-01309-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 11/28/2022] [Indexed: 12/28/2022]
Abstract
PURPOSE Our study aimed to examine whether receipt of follow-up care plans is associated with greater guideline-concordant CRC screening stratified by breast, prostate, and lung cancer survivors. METHODS We used data from years 2016, 2018, and 2020 of the Behavioral Risk Factor Surveillance System on 3339 eligible treatment-utilizing cancer survivors with complete treatment. We performed descriptive statistics and multivariable logistic regression to examine the mentioned association. RESULTS We observed that 83.9% of breast and 88.2% of prostate cancer survivors with follow-care plans received CRC screening (p-value < 0.001). The lowest CRC screening use was observed among lung cancer (70.8%). In multivariable analysis, receipt of follow-up care plans was strongly associated with greater odds of receiving CRC screening in breast (OR, 2.67; 95% CI: 1.71-4.16) and prostate (OR, 3.81; 95% CI: 2.30-6.31) cancer survivors. Regardless of provider type, 84 to 88% reduced likelihood of receipt of CRC screening when they received follow-up care plans among lung cancer survivors. Among those without follow-up care plans, breast (OR, 0.29; 95% CI: 0.09-0.92) and lung (OR, 0.05; 95% CI: 0.01-0.25) cancer survivors who received care from general practices were less likely to receive CRC screening compared to those who received care from non-general practices. CONCLUSIONS Receipt of follow-up care plans was associated with greater CRC screening use in breast and prostate cancers. Lung cancer survivors demonstrated lower screening use despite receipt of follow-up care plans. IMPLICATION FOR CANCER SURVIVORS Patient and provider communication regarding CRC screening recommendation should be included in their follow-up care plans.
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Affiliation(s)
- Meng-Han Tsai
- Cancer Prevention, Control, & Population Health Program, Georgia Cancer Center, Department of Medicine, Medical College of Georgia, Augusta University, 1410 Laney Walker Boulevard CN-2116, Augusta, GA, 30912, USA.
- Georgia Prevention Institute, Augusta University, 1457 Walton Way, Augusta, GA, 30901, USA.
| | - Malcolm S Bevel
- Cancer Prevention, Control, & Population Health Program, Georgia Cancer Center, Department of Medicine, Medical College of Georgia, Augusta University, 1410 Laney Walker Boulevard CN-2116, Augusta, GA, 30912, USA
| | - Sydney E Andrzejak
- Cancer Prevention, Control, & Population Health Program, Georgia Cancer Center, Department of Medicine, Medical College of Georgia, Augusta University, 1410 Laney Walker Boulevard CN-2116, Augusta, GA, 30912, USA
| | - Justin X Moore
- Cancer Prevention, Control, & Population Health Program, Georgia Cancer Center, Department of Medicine, Medical College of Georgia, Augusta University, 1410 Laney Walker Boulevard CN-2116, Augusta, GA, 30912, USA
- Institute of Public and Preventive Health, Augusta University, 1120 15Th Street, Augusta, GA, 30912, USA
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Hoshi S, Bilim V, Hoshi K, Ogawa Y, Kato T, Urano K, Yamada T, Sakagami R, Kudo T, Numahata K, Sasagawa I. Double Primary Cancer of the Prostate and Urothelial Cancer: A Single Institution Experience. J Pers Med 2024; 14:510. [PMID: 38793091 PMCID: PMC11121936 DOI: 10.3390/jpm14050510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/03/2024] [Accepted: 05/06/2024] [Indexed: 05/26/2024] Open
Abstract
Prostate cancer (PCa) ranks as the second most common cancer in Japanese males, while bladder cancer (BC) holds the tenth spot. Among double urological cancers, the incidence of synchronous or metachronous BC and PCa is the highest. Reports on upper urinary tract (UUT) urothelial cancer (UC) in PCa patients are limited. Here, we present three cases of metachronous PCa and BC, with subsequent diagnosis of ureteral and renal pelvic cancer during the course of the disease. In the follow-up of patients with urological cancers, it is important to be aware not only of the progression of the initial cancer but also the potential development of a second cancer.
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Affiliation(s)
- Senji Hoshi
- Department of Urology, Yamagata Tokushukai Hospital, Yamagata 990-0834, Japan; (S.H.); (K.H.); (I.S.)
| | - Vladimir Bilim
- Department of Urology, Kameda Daiichi Hospital, Niigata 950-0165, Japan
| | - Kiyotsugu Hoshi
- Department of Urology, Yamagata Tokushukai Hospital, Yamagata 990-0834, Japan; (S.H.); (K.H.); (I.S.)
| | - Yoshihiro Ogawa
- Sendai Radiation Oncology & Imaging Clinic, Sendai City 981-3121, Japan;
| | - Tomoyuki Kato
- Department of Urology, Yamagata City Hospital Saiseikan, Yamagata 990-8533, Japan;
| | - Kota Urano
- Department of Urology, Yamagata Prefectural Central Hospital, Yamagata 990-2292, Japan; (K.U.); (T.Y.); (R.S.); (T.K.); (K.N.)
| | - Tomoya Yamada
- Department of Urology, Yamagata Prefectural Central Hospital, Yamagata 990-2292, Japan; (K.U.); (T.Y.); (R.S.); (T.K.); (K.N.)
| | - Rie Sakagami
- Department of Urology, Yamagata Prefectural Central Hospital, Yamagata 990-2292, Japan; (K.U.); (T.Y.); (R.S.); (T.K.); (K.N.)
| | - Takashi Kudo
- Department of Urology, Yamagata Prefectural Central Hospital, Yamagata 990-2292, Japan; (K.U.); (T.Y.); (R.S.); (T.K.); (K.N.)
| | - Kenji Numahata
- Department of Urology, Yamagata Prefectural Central Hospital, Yamagata 990-2292, Japan; (K.U.); (T.Y.); (R.S.); (T.K.); (K.N.)
| | - Isoji Sasagawa
- Department of Urology, Yamagata Tokushukai Hospital, Yamagata 990-0834, Japan; (S.H.); (K.H.); (I.S.)
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McGuire V, Lichtensztajn DY, Tao L, Yang J, Clarke CA, Wu AH, Wilkens L, Glaser SL, Park SL, Cheng I. Variation in patterns of second primary malignancies across U.S. race and ethnicity groups: a Surveillance, Epidemiology, and End Results (SEER) analysis. Cancer Causes Control 2024; 35:799-815. [PMID: 38206498 DOI: 10.1007/s10552-023-01836-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 11/25/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE One in six incident cancers in the U.S. is a second primary cancer (SPC). Although primary cancers vary considerably by race and ethnicity, little is known about the population-based occurrence of SPC across these groups. METHODS Using Surveillance, Epidemiology, and End Results (SEER) 12 data and relative to the general population, we calculated standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for SPC among 2,457,756 Hispanics, non-Hispanic Asian American/Pacific Islanders (NHAAPI), non-Hispanic black (NHB), and non-Hispanic whites (NHW) cancer survivors aged 45 years or older when diagnosed with a first primary cancer (FPC) from 1992 to 2015. RESULTS The risk of second primary bladder cancer after first primary prostate cancer was higher than expected in Hispanic (SIR = 1.18, 95% CI: 1.01-1.38) and NHAAPI (SIR = 1.41, 95% CI: 1.20-1.65) men than NHB and NHW men. Among women with a primary breast cancer, Hispanic, NHAAPI, and NHB women had a nearly 1.5-fold higher risk of a second primary breast cancer, while NHW women had a 6% lower risk. Among men with prostate cancer whose SPC was diagnosed 2 to <12 months, NHB men were at higher risk for colorectal cancer and Hispanic and NHW men for non-Hodgkin's lymphoma. In the same time frame for breast cancer survivors, Hispanic and NHAAPI women were significantly more likely than NHB and NHW women to be diagnosed with a second primary lung cancer. CONCLUSION Future studies of SPC should investigate the role of shared etiologies, stage of diagnosis, treatment, and lifestyle factors after cancer survival across different racial and ethnic populations.
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Affiliation(s)
- Valerie McGuire
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, 94158-2549, USA.
| | - Daphne Y Lichtensztajn
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, 94158-2549, USA
- Greater Bay Area Cancer Registry, Cancer Prevention Institute of California, Fremont, CA, USA
| | - Li Tao
- Greater Bay Area Cancer Registry, Cancer Prevention Institute of California, Fremont, CA, USA
| | - Juan Yang
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, 94158-2549, USA
- Greater Bay Area Cancer Registry, Cancer Prevention Institute of California, Fremont, CA, USA
| | - Christina A Clarke
- Greater Bay Area Cancer Registry, Cancer Prevention Institute of California, Fremont, CA, USA
| | - Anna H Wu
- Department of Population and Public Health Science, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lynne Wilkens
- Epidemiology Program, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Sally L Glaser
- Greater Bay Area Cancer Registry, Cancer Prevention Institute of California, Fremont, CA, USA
| | | | - Iona Cheng
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, 94158-2549, USA
- Greater Bay Area Cancer Registry, Cancer Prevention Institute of California, Fremont, CA, USA
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Monda S, Pratsinis M, Lui H, Noel O, Chandrasekar T, Evans CP, Dall'Era MA. Secondary Bladder Cancer After Prostate Cancer Treatment: An Age-matched Comparison Between Radiation and Surgery. Eur Urol Focus 2024; 10:448-453. [PMID: 37722954 DOI: 10.1016/j.euf.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/18/2023] [Accepted: 09/06/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND Secondary malignancy is a long-term risk of radiation. External beam radiation therapy (EBRT) for prostate cancer treatment has been associated with later development of bladder cancer and worse bladder cancer features. OBJECTIVE We sought to provide an updated comparison of the long-term risk of bladder cancer after different localized prostate cancer treatments. DESIGN, SETTING, AND PARTICIPANTS Using the Surveillance, Epidemiology, and End Results (SEER) cancer registry, we compared an age-matched subset of patients who underwent radical prostatectomy (RP) with those who underwent EBRT, brachytherapy (BT), EBRT + BT, and RP followed by EBRT (RPtoEBRT) between 2000 and 2018. Our final cohort included 261 609 patients with a median follow-up of 11.6 yr. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Our primary outcomes were time to bladder cancer diagnosis, muscle-invasive bladder cancer diagnosis, and bladder cancer death. We used cause-specific hazard models considering death as a competing event. A similar analysis was performed on lung cancer, as a surrogate marker for smoking. We also compared proportions of variant histology, high-grade, and invasive disease among bladder cancers that occurred after radiation versus RP using chi-square testing. RESULTS AND LIMITATIONS All radiation groups were associated with bladder cancer diagnosis; hazard ratios (HRs) were 1.72, 1.85, 1.80, and 1.53 for EBRT, BT, EBRT + BT, and RPtoEBRT, respectively, using RP as a referent (all p < 0.001). HRs for bladder cancer death were even higher: 2.39, 2.57, and 3.02 for EBRT, BT, and EBRT + BT, respectively (all p < 0.001), except for RPtoEBRT (HR 1.43, p = 0.28). Lung cancer diagnosis was also associated with radiation but at lower HRs-1.63, 1.32, 1.42, and 1.30 for EBRT, BT, EBRT + BT, and RPtoEBRT, respectively (all p < 0.001). There were a higher proportion of ≥T2, ≥T3, and sarcomatoid variant bladder cancers after radiation (all p < 0.01) CONCLUSIONS: The risk of developing and dying from bladder cancer is increased in patients treated with radiation compared with those treated with RP. The risk was similar for BT and EBRT. Bladder cancers after radiation are more likely to be sarcomatoid variant and present as muscle invasive. PATIENT SUMMARY We observed the rates of bladder cancer after patients had undergone surgery or radiation for prostate cancer, and found higher rates of bladder cancer after radiation. We also observed that bladder cancers that occur after radiation tend to be more aggressive.
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Affiliation(s)
- Steven Monda
- Department of Urologic Surgery, University of California Davis, Sacramento, CA, USA.
| | - Manolis Pratsinis
- Department of Urologic Surgery, University of California Davis, Sacramento, CA, USA; Department of Urology, St. Gallen Hospital, St. Gallen, Switzerland
| | - Hansen Lui
- Department of Urologic Surgery, University of California Davis, Sacramento, CA, USA
| | - Onika Noel
- Department of Urologic Surgery, University of California Davis, Sacramento, CA, USA; Department of Urology, University of Texas Health San Antonio, San Antonio, TX, USA
| | | | - Christopher P Evans
- Department of Urologic Surgery, University of California Davis, Sacramento, CA, USA
| | - Marc A Dall'Era
- Department of Urologic Surgery, University of California Davis, Sacramento, CA, USA
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Tsai MH, Moore JX, Odhiambo LA, Andrzejak SE, Tingen MS. Colorectal cancer screening utilization among breast, cervical, prostate, skin, and lung cancer survivors. J Cancer Surviv 2024; 18:541-552. [PMID: 36217067 PMCID: PMC9549837 DOI: 10.1007/s11764-022-01258-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/12/2022] [Indexed: 11/04/2022]
Abstract
PURPOSE To examine whether sociodemographic characteristics, access to care, risk behavior factors, and chronic health conditions were associated with colorectal cancer (CRC) screening utilization among breast, cervical, prostate, skin, and lung cancer survivors. METHODS We analyzed the 2020 Behavioral Risk Factor Surveillance System (BRFSS) data on 9780 eligible cancer survivors. Descriptive statistics and multivariable logistic regression models were applied to assess the association between guideline-concordant CRC screening and the mentioned characteristics. RESULTS Overall, 81.9%, 65%, 88%,78.1%, and 80.1% of breast, cervical, prostate, skin, and lung cancer survivors received CRC screening, respectively (p-value < 0.001). In multivariable analysis, breast, cervical, and skin cancer survivors aged 60 years or older were associated with higher odds of receiving CRC screening. Respondents that had their recency of routine checkup two or more years before had lower odds of having CRC screening among cervical (OR = 0.06; 95% CI, 0.02-0.22), prostate (OR = 0.26; 95% CI, 0.14-0.49), and skin cancer (OR = 0.50; 95% CI, 0.36-0.70) survivors. The presence of chronic diseases was also associated with guideline-concordant CRC screening among breast, prostate, and skin cancer survivors. CONCLUSIONS Our findings provide important evidence on potential factors that are associated with guideline-concordant CRC screening utilization across different cancer survivors, which include older age, recency of routine checkup, and multiple chronic diseases. Moreover, variation in CRC screening utilization across cancer survivors may highlight missed opportunities for secondary cancer prevention. IMPLICATIONS FOR CANCER SURVIVORS Establishing clear CRC screening guidelines and including patient-provider communication on recommendation in cancer survivorship care may increase adherence to CRC screening.
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Affiliation(s)
- Meng-Han Tsai
- Cancer Prevention, Control, and Population Health Program, Georgia Cancer Center, Department of Medicine, Medical College of Georgia, Augusta University, 1410 Laney Walker Boulevard CN-2116, Augusta, GA, 30912, USA.
- Georgia Prevention Institute, Augusta University, 1457 Walton Way, Augusta, GA, 30901, USA.
| | - Justin X Moore
- Cancer Prevention, Control, and Population Health Program, Georgia Cancer Center, Department of Medicine, Medical College of Georgia, Augusta University, 1410 Laney Walker Boulevard CN-2116, Augusta, GA, 30912, USA
- Institute of Public and Preventive Health, Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
| | - Lorriane A Odhiambo
- Institute of Public and Preventive Health, Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
| | - Sydney E Andrzejak
- Cancer Prevention, Control, and Population Health Program, Georgia Cancer Center, Department of Medicine, Medical College of Georgia, Augusta University, 1410 Laney Walker Boulevard CN-2116, Augusta, GA, 30912, USA
| | - Martha S Tingen
- Cancer Prevention, Control, and Population Health Program, Georgia Cancer Center, Department of Medicine, Medical College of Georgia, Augusta University, 1410 Laney Walker Boulevard CN-2116, Augusta, GA, 30912, USA
- Georgia Prevention Institute, Augusta University, 1457 Walton Way, Augusta, GA, 30901, USA
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Wu KY, Cheong IS, Lai JN, Hu CY, Hung KC, Chen YT, Chiu LT, Tsai HT, Jou YC, Tzai TS, Tsai YS. Risk of secondary primary malignancies in survivors of upper tract urothelial carcinoma: A nationwide population-based analysis. Cancer Epidemiol 2024; 89:102536. [PMID: 38281454 DOI: 10.1016/j.canep.2024.102536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/16/2024] [Accepted: 01/19/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND To investigate the cancer types and risk factors of secondary primary malignancy (SPM) in patients with upper tract urothelial carcinoma (UTUC) in Taiwan. METHODS Using National Health Insurance Research Dataset and catastrophic illness registry, we enrolled newly diagnosed UTUC patients from 2000 to 2013. Those without catastrophic illness registration were excluded from the study. The cancer types and hazard ratios (HRs) of subsequent SPMs were calculated according to the antecedent malignancy. We analyzed the risk factors for developing SPMs using multivariate Cox proportional hazard models. RESULTS A total of 9050 UTUC patients were registered and 2187 (24.2%) patients developed SPMs during the study period. As compared with primary UTUC, the relative risk ratios of SPM was 2.5 folds and 18% higher in those with antecedent non-UC malignancy and with bladder cancer history, respectively. Totally, 387 (37.8%) of 1022 UTUC patients with antecedent non-UC malignancy developed subsequent SPM after UTUC diagnosis. The antecedent and subsequent cancer types are similar and kidney cancer is most common, followed by hepatoma. Multivariate analysis showed that a history of antecedent non-UC malignancy is the most unfavorable factor for SPM development (HR, 2.50; 95% CI, 2.23-2.81), followed by liver disease, male gender, antecedent bladder cancer history, age ≥ 75 years, and chronic kidney disease. CONCLUSIONS Our study, conducted in Taiwan and involving 9050 UTUC patients, meticulously examined the types of SPM and the associated risk factors. Our research unearthed several pivotal discoveries: a preceding history of non-UC malignancies emerged as the single most influential factor contributing to the occurrence of subsequent cancers, followed by liver disease, male gender, antecedent bladder cancer history, age ≥75 years, and chronic kidney disease. Futhermore, kidney cancer emerged as the predominant subsequent malignancy, closely trailed by hepatoma..
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Affiliation(s)
- Kuan-Yu Wu
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
| | - Ian-Seng Cheong
- Department of Urology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi 600, Taiwan
| | - Jung-Nien Lai
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan; Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan
| | - Che-Yuan Hu
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
| | - Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, No.901, ChungHwa Road, Yung Kung Dist, Tainan 710, Taiwan; Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan 717, Taiwan
| | - Yi-Ting Chen
- Department of Anesthesiology, Chia-Yi Chang Gung Memorial Hospital, Chia-Yi 613, Taiwan
| | - Lu-Ting Chiu
- Management office for Health Data, China Medical University Hospital, Taichung 404, Taiwan
| | - Hsin-Tzu Tsai
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
| | - Yeong-Chin Jou
- Division of Urology, Department of Surgery, St Martin De Porres Hospital, Chia-Yi 600, Taiwan
| | - Tzong-Shin Tzai
- Department of Urology, An Nan Hospital, China Medical University, Tainan 709, Taiwan.
| | - Yuh-Shyan Tsai
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan.
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9
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Zhan X, Chen T, Xiong S, Li S, Deng X, Xu S, Fu B, Deng J. Causal relationship between prostate cancer and 12 types of cancers: multivariable and bidirectional Mendelian randomization analyses. Int Urol Nephrol 2024; 56:547-556. [PMID: 37740849 DOI: 10.1007/s11255-023-03793-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 09/03/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND Previous observational studies have shown an association between certain cancers and the subsequent risk of prostate cancer (PCa). However, the causal relationship between these cancers and PCa is still unclear. This study aimed to investigate the causal relationship between 12 common cancers and the risk of PCa. METHODS We employed genome-wide association studies (GWAS) to perform forward and reverse Mendelian randomization (MR) within two-sample frameworks. Furthermore, we conducted multivariable MR analyses to investigate the relationships between different types of cancer. In addition, multiple sensitivity analysis methods were employed to assess the robustness of our findings. RESULTS Our univariable MR analysis showed that genetically predicted hematological cancer was associated with a reduced risk of PCa (OR: 0.911, 95% CI 0.89-0.922, P = 0.03). Furthermore, MR analysis demonstrates that genetically predicted occurrence of thyroid gland and endocrine gland cancer also raised the risk of PCa (all P < 0.05). Multivariable analysis showed that thyroid gland cancer exhibited a higher incidence of PCa (OR: 1.12, 95% CI: 1.08-1.16, P = 0.008). In the reverse MR analysis, we found no significant inverse causal associations between PCa and 12 types of cancers. CONCLUSION In summary, this study provided insights into the causal relationships between various types of cancer and PCa. Hematological cancer was suggested to associate with a lower risk of PCa, while thyroid gland cancer and endocrine gland cancer might increase the risk. These findings contribute to the understanding of genetic factors related to PCa and its potential associations with other cancers.
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Affiliation(s)
- Xiangpeng Zhan
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Tao Chen
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Situ Xiong
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Sheng Li
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xinxi Deng
- Department of Urology, Jiu Jiang First People's Hospital, Jiujiang, Jiangxi, China
| | - Songhui Xu
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Bin Fu
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Jun Deng
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
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10
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Tang W, Zhou LJ, Zhang WQ, Jia YJ, Ge MW, Hu FH, Chen HL. Association of radiotherapy for prostate cancer and second primary colorectal cancer: a US population-based analysis. Tech Coloproctol 2023; 28:14. [PMID: 38095784 DOI: 10.1007/s10151-023-02883-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 11/17/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Radiotherapy (RT) is a common treatment for prostate cancer, yet the risk of second primary colorectal cancer (SPCRC) in patients with prostate cancer undergoing RT has not been adequately studied. METHODS This study employed a population-based cohort design using the US Surveillance, Epidemiology, and End Results (SEER) database to identify individuals diagnosed between January 1975 and December 2015. The cumulative incidence of SPCRC was estimated using Fine-Gray competing risk regression. Poisson regression analysis was used to estimate the risk associated with RT. Survival outcomes of patients with SPCRC were evaluated using the Kaplan-Meier method. RESULTS A total of 287,607 patients diagnosed with prostate cancer were identified. The cumulative incidences were higher in patients who did not receive RT (2.00%) compared to those who underwent RT (2.47%) after 25 years. After adjustment for multiple variables, RT was associated with an increased risk of developing combined SPCRC (adjusted HR 1.590). Additionally, the overall survival was significantly lower in patients who developed colorectal cancer after receiving RT as compared to those who did not receive RT. CONCLUSION These findings underscore the need for diligent long-term monitoring and effective management strategies to detect SPCRC in patients treated with RT for prostate cancer.
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Affiliation(s)
- W Tang
- Medical School, Nantong University, Nantong, China
| | - L-J Zhou
- Nursing Department, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, China
| | - W-Q Zhang
- Medical School, Nantong University, Nantong, China
| | - Y-J Jia
- Medical School, Nantong University, Nantong, China
| | - M-W Ge
- Medical School, Nantong University, Nantong, China
| | - F-H Hu
- Medical School, Nantong University, Nantong, China
| | - H-L Chen
- School of Public Health, Nantong University, 9#Seyuan Road, Nantong, 226000, Jiangsu, China.
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11
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Leung TH, El Helali A, Wang X, Ho JC, Pang H. Trends and age, sex, and race disparities in time to second primary cancer from 1990 to 2019. Cancer Med 2023; 12:22316-22324. [PMID: 38063337 PMCID: PMC10757087 DOI: 10.1002/cam4.6785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 10/09/2023] [Accepted: 11/23/2023] [Indexed: 12/31/2023] Open
Abstract
BACKGROUND Despite the growth in primary cancer (PC) survivors, the trends and disparities in this population have yet to be comprehensively examined using competing risk analysis. The objective is to examine trends in time to second primary cancer (SPC) and to characterize age, sex, and racial disparities in time-to-SPC. METHODS A retrospective analysis was conducted based on Surveillance, Epidemiology, and End Results (SEER). Two datasets for this study are (1) the discovery dataset with patients from SEER-8 (1990-2019) and (2) the validation dataset with patients from SEER-17 (2000-2019), excluding those in the discovery dataset. Patients were survivors of lung, colorectal, breast (female only), and prostate PCs. RESULTS The 5-year SPC cumulative incidences of lung PC increased from 1990 to 2019, with the cumulative incidence ratio being 1.73 (95% confidence intervals [CI], 1.64-1.82; p < 0.001). Age disparities among all PCs remained from 2010 to 2019, and the adjusted HRs (aHRs) of all PCs were above 1.43 when those below 65 were compared with those 65 and above. Sex disparity exists among colorectal and lung PC survivors. Racial disparities existed among non-Hispanic (NH) Black breast PC survivors (aHR: 1.11; 95% CI: 1.07-1.17; p < 0.001). The types of SPC vary according to PC and sex. CONCLUSIONS Over the past three decades, there has been a noticeably shortened time-to-SPC among lung PC survivors. This is likely attributed to the reduced number of lung cancer deaths due to advancements in effective treatments. However, disparities in age, sex, and race still exist, indicating that further effort is needed to close the gap.
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Affiliation(s)
- Tiffany H. Leung
- Department of Medicine, Li Ka Shing Faculty of MedicineThe University of Hong KongHong KongChina
- School of Public Health, Li Ka Shing Faculty of MedicineThe University of Hong KongHong KongChina
| | - Aya El Helali
- Department of Clinical Oncology, School of Clinical Medicine, Li Ka Shing Faculty of MedicineThe University of Hong KongHong KongChina
| | - Xiaofei Wang
- Department of Biostatistics and Bioinformatics, School of MedicineDuke UniversityDurhamNorth CarolinaUSA
| | - James C. Ho
- Department of Medicine, Li Ka Shing Faculty of MedicineThe University of Hong KongHong KongChina
| | - Herbert Pang
- School of Public Health, Li Ka Shing Faculty of MedicineThe University of Hong KongHong KongChina
- Department of Biostatistics and Bioinformatics, School of MedicineDuke UniversityDurhamNorth CarolinaUSA
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12
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Wang Y, Chen R, Deng X, Jiang X. Incidence and associated factors of developing second pelvic malignant neoplasms among prostate cancer patients treated with radiotherapy. Front Oncol 2023; 13:1260325. [PMID: 38044985 PMCID: PMC10693410 DOI: 10.3389/fonc.2023.1260325] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 11/03/2023] [Indexed: 12/05/2023] Open
Abstract
Objective To identify risk factors of secondary pelvic malignant neoplasms (SPMNs) among prostate cancer (PCa) patients treated with radiotherapy. Simultaneously, population-based data were used to validate the high risk of SPMNs in PCa patients with radiotherapy. Materials and methods We identified male patients diagnosed with PCa (localized and regional) as the first primary cancer and pelvic malignant neoplasm (including bladder and rectal cancer) as secondary cancer from Surveillance, Epidemiology, and End Results database (1975-2020). An external validation cohort was obtained from the First Affiliated Hospital of Nanchang University. The Fine-Gray competing risk regression and Poisson regression were utilized to evaluate the risk of SPMNs development. Poisson regression was also performed to calculate the standardized incidence ratio (SIR). The Kaplan-Meier method was used to assess the overall survival (OS) of patients with SPMNs. Results 89397 PCa patients treated with radiotherapy were enrolled. We identified associated factors of SPMNs, including age at diagnosis, race, year of diagnosis, marital status, radiation strategy and latency. In the multivariable competing risk regression model and Poisson regression model, a significantly higher risk of SPMNs development was observed in patients over 50 years(P<0.05), white patients(P<0.001), unmarried patients and treated with brachytherapy combined with external beam radiotherapy or brachytherapy(P<0.05). Patients treated with radiotherapy had a higher bladder and rectal cancer incidence than the general population. Patients who developed SPMNs showed poorer OS. Conclusion We identified several risk factors associated with SPMNs and confirmed a relatively higher incidence of bladder and rectal cancer among PCa patients with radiotherapy. These results help tailor treatment and surveillance strategies.
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Affiliation(s)
- Youbiao Wang
- Department of Urology, The Second People’s Hospital of Jingdezhen City, Jingdezhen, Jiangxi, China
| | - Ru Chen
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xinxi Deng
- Department of Urology, Jiujiang First People’s Hospital, Jiujiang, Jiangxi, China
| | - Xinghua Jiang
- Department of Urology, The Second People’s Hospital of Jingdezhen City, Jingdezhen, Jiangxi, China
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13
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Ruan X, Huang D, Zhan Y, Huang J, Huang J, Ng ATL, Tsu JHL, Na R. Risk of second primary cancers after a diagnosis of first primary cancer: A pan-cancer analysis and Mendelian randomization study. eLife 2023; 12:e86379. [PMID: 37917154 PMCID: PMC10622143 DOI: 10.7554/elife.86379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 09/29/2023] [Indexed: 11/03/2023] Open
Abstract
Background The risk of second primary cancers (SPC) is increasing after the first primary cancers (FPC) are diagnosed and treated. The underlying causal relationship remains unclear. Methods We conducted a pan-cancer association (26 cancers) study in the Surveillance, Epidemiology, and End Results (SEER) database (non-Hispanic whites). The standardized incidence ratio (SIR) was estimated as the risk of SPCs in cancer survivors based on the incidence in the general population. Furthermore, the causal effect was evaluated by two-sample Mendelian Randomization (MR, 13 FPCs) in the UK Biobank (UKB, n=459,136,, European whites) and robust analysis (radial MR and Causal Analysis Using Summary Effect estimates, CAUSE). Results We found 11 significant cross-correlations among different cancers after harmonizing SIR and MR results. Whereas only 4 of them were confirmed by MR to have a robust causal relationship. In particular, patients initially diagnosed with oral pharyngeal cancer would have an increased risk of non-Hodgkin lymphoma (SIRSEER = 1.18, 95%Confidence Interval [CI]:1.05-1.31, ORradial-MR=1.21, 95% CI:1.13-1.30, p=6.00 × 10-3; ORcause = 1.17, 95% CI:1.05-1.31, p=8.90 × 10-3). Meanwhile, ovary cancer was identified to be a risk factor for soft tissue cancer (SIRSEER = 1.72, 95%Confidence Interval [CI]:1.08-2.60, ORradial-MR=1.39, 95% CI:1.22-1.58, p=1.07 × 10-3; ORcause = 1.36, 95% CI:1.16-1.58, p=0.01). And kidney cancer was likely to cause the development of lung cancer (SIRSEER = 1.28, 95%Confidence Interval [CI]:1.22-1.35, ORradial-MR=1.17, 95% CI:1.08-1.27, p=6.60 × 10-3; ORcause = 1.16, 95% CI:1.02-1.31, p=0.05) and myeloma (SIRSEER = 1.54, 95%Confidence Interval [CI]:1.33-1.78, ORradial-MR=1.72, 95% CI:1.21-2.45, p=0.02; ORcause = 1.49, 95% CI:1.04-2.34, p=0.02). Conclusions A certain type of primary cancer may cause another second primary cancer, and the profound mechanisms need to be studied in the future. Funding This work was in supported by grants from National Natural Science Foundation of China (Grant No. 81972645), Innovative research team of high-level local universities in Shanghai, Shanghai Youth Talent Support Program, intramural grant of The University of Hong Kong to Dr. Rong Na, and Shanghai Sailing Program (22YF1440500) to Dr. Da Huang.
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Affiliation(s)
- Xiaohao Ruan
- Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Da Huang
- Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Yongle Zhan
- Division of Urology, Department of Surgery, Queen Mary Hospital, The University of Hong KongHong KongChina
| | - Jingyi Huang
- Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Jinlun Huang
- Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Ada Tsui-Lin Ng
- Division of Urology, Department of Surgery, Queen Mary Hospital, The University of Hong KongHong KongChina
| | - James Hok-Leung Tsu
- Division of Urology, Department of Surgery, Queen Mary Hospital, The University of Hong KongHong KongChina
| | - Rong Na
- Division of Urology, Department of Surgery, Queen Mary Hospital, The University of Hong KongHong KongChina
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14
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Shore R, Zhang J, Ye W, Stattin P, Lindblad M. Risk of colorectal adenocarcinoma in men receiving androgen deprivation therapy for prostate cancer; a nationwide cohort study. Cancer Causes Control 2023; 34:949-961. [PMID: 37341814 PMCID: PMC10533601 DOI: 10.1007/s10552-023-01736-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 06/06/2023] [Indexed: 06/22/2023]
Abstract
PURPOSE To assess whether androgens play a role in explaining the sex related differences in the incidence of colorectal cancer (CRC). METHODS A nationwide matched cohort study was conducted employing the Prostate Cancer data Base Sweden (PCBaSe) 4.0 during the study period 2006-2016. Prostate cancer (PC) patients receiving androgen deprivation therapy (ADT) were treated as exposed. Prostate cancer-free men from the general population were randomly selected and matched to the index case by birth year and county of residence, forming the unexposed group. All were followed until a diagnosis of CRC, death, emigration, or end of the study period. The risk of CRC among ADT exposed PC patients compared to unexposed cancer-free men was calculated using a flexible parametric survival model and expressed as hazard ratios (HRs) with 95% confidence intervals (CIs). RESULTS There was an increased risk of CRC among ADT exposed PC patients compared to unexposed cancer-free men (HR 1.27 [95% CI 1.15-1.41]), in particular an increased risk of adenocarcinoma of the colon (HR 1.33 [95% CI 1.17-1.51]) and more specifically an increased risk of adenocarcinoma of the distal colon (HR 1.53 [95% CI 1.26-1.85]). Examination of latency effects yielded significantly decreased HRs over time for CRC (p = 0.049 for trend). CONCLUSIONS This population-based study found an increased risk of CRC among PC patients exposed to ADT, specifically adenocarcinoma of the distal colon, which indicates an increased association between ADT (PC + ADT) and CRC but not a positive dose-response trend questioning a true causal effect.
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Affiliation(s)
- Richard Shore
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.
- Function Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.
| | - Ji Zhang
- Department of Medical Epidemiology and Biostatistics (MEB), Karolinska Institutet, Stockholm, Sweden
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics (MEB), Karolinska Institutet, Stockholm, Sweden
| | - Pär Stattin
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Mats Lindblad
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
- Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden
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15
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Patini R, Cordaro M, Marchesini D, Scilla F, Gioco G, Rupe C, D'Agostino MA, Lajolo C. Is Systemic Immunosuppression a Risk Factor for Oral Cancer? A Systematic Review and Meta-Analysis. Cancers (Basel) 2023; 15:3077. [PMID: 37370688 DOI: 10.3390/cancers15123077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 06/29/2023] Open
Abstract
Even if the relationship between immunosuppression and increased incidence of systemic cancers is well known, there is less awareness about the risk of developing oral cancer in immunosuppressed patients. The aim of this review was to evaluate the association between immunosuppression and the development of oral cancer. Two authors independently and, in duplicate, conducted a systematic literature review of international journals and electronic databases (MEDLINE via OVID, Scopus, and Web of Science) from their inception to 28 April 2023. The assessment of risk of bias and overall quality of evidence was performed using the Newcastle-Ottawa Scale and GRADE system. A total of 2843 articles was identified, of which 44 met the inclusion criteria and were included in either the qualitative or quantitative analysis. The methodological quality of the included studies was generally high or moderate. The quantitative analysis of the studies revealed that immunosuppression should be considered a risk factor for the development of oral cancer, with a percentage of increased risk ranging from 0.2% to 1% (95% CI: 0.2% to 1.4%). In conclusion, the results suggest that a constant and accurate follow-up should be reserved for all immunosuppressed patients as a crucial strategy to intercept lesions that have an increased potential to evolve into oral cancer.
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Affiliation(s)
- Romeo Patini
- Department of Head, Neck and Sense Organs, School of Dentistry, Catholic University of Sacred Heart, Fondazione Policlinico Universitario "A. Gemelli"-IRCCS Rome, 00135 Rome, Italy
| | - Massimo Cordaro
- Department of Head, Neck and Sense Organs, School of Dentistry, Catholic University of Sacred Heart, Fondazione Policlinico Universitario "A. Gemelli"-IRCCS Rome, 00135 Rome, Italy
| | - Denise Marchesini
- Department of Head, Neck and Sense Organs, School of Dentistry, Catholic University of Sacred Heart, Fondazione Policlinico Universitario "A. Gemelli"-IRCCS Rome, 00135 Rome, Italy
| | - Francesco Scilla
- Department of Head, Neck and Sense Organs, School of Dentistry, Catholic University of Sacred Heart, Fondazione Policlinico Universitario "A. Gemelli"-IRCCS Rome, 00135 Rome, Italy
| | - Gioele Gioco
- Department of Head, Neck and Sense Organs, School of Dentistry, Catholic University of Sacred Heart, Fondazione Policlinico Universitario "A. Gemelli"-IRCCS Rome, 00135 Rome, Italy
| | - Cosimo Rupe
- Department of Head, Neck and Sense Organs, School of Dentistry, Catholic University of Sacred Heart, Fondazione Policlinico Universitario "A. Gemelli"-IRCCS Rome, 00135 Rome, Italy
| | - Maria Antonietta D'Agostino
- Department of Geriatric and Orthopedic Sciences, Catholic University of Sacred Heart, Fondazione Policlinico Universitario "A. Gemelli"-IRCCS Rome, 00135 Rome, Italy
| | - Carlo Lajolo
- Department of Head, Neck and Sense Organs, School of Dentistry, Catholic University of Sacred Heart, Fondazione Policlinico Universitario "A. Gemelli"-IRCCS Rome, 00135 Rome, Italy
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16
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Higano CS, George DJ, Shore ND, Sartor O, Miller K, Conti PS, Sternberg CN, Saad F, Sade JP, Bellmunt J, Smith MR, Chandrawansa K, Sandström P, Verholen F, Tombal B. Clinical outcomes and treatment patterns in REASSURE: planned interim analysis of a real-world observational study of radium-223 in metastatic castration-resistant prostate cancer. EClinicalMedicine 2023; 60:101993. [PMID: 37251627 PMCID: PMC10209672 DOI: 10.1016/j.eclinm.2023.101993] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 04/18/2023] [Accepted: 04/18/2023] [Indexed: 05/31/2023] Open
Abstract
Background Radium-223, a targeted alpha therapy, is approved to treat bone-dominant metastatic castration-resistant prostate cancer (mCRPC), based on significantly prolonged overall survival versus placebo and a favourable safety profile in the phase 3 ALSYMPCA study. ALSYMPCA was conducted when few other treatment options were available, and prospectively collected data are limited on the use of radium-223 in the current mCRPC treatment landscape. We sought to understand long-term safety and treatment patterns in men who received radium-223 in real-world clinical practice. Methods REASSURE (NCT02141438) is a global, prospective, observational study of radium-223 in men with mCRPC. Primary outcomes are adverse events (AEs), including treatment-emergent serious AEs (SAEs) and drug-related AEs during and ≤30 days after radium-223 completion, grade 3/4 haematological toxicities ≤6 months after last radium-223 dose, drug-related SAEs after radium-223 therapy completion, and second primary malignancies. Findings Data collection commenced on Aug 20, 2014, and the data cutoff date for this prespecified interim analysis was Mar 20, 2019 (median follow-up 11.5 months [interquartile range 6.0-18.6]), 1465 patients were evaluable. For second primary malignancies, 1470 patients were evaluable, 21 (1%) of whom had a total of 23 events. During radium-223 therapy, 311 (21%) of 1465 patients had treatment-emergent SAEs, and 510 (35%) had drug-related AEs. In the 6 months after completion of radium-223 therapy, 214 (15%) patients had grade 3/4 haematological toxicities. Eighty patients (5%) had post-treatment drug-related SAEs. Median overall survival was 15.6 months (95% confidence interval 14.6-16.5) from radium-223 initiation. Patient-reported pain scores declined or stabilised. Seventy (5%) patients had fractures. Interpretation REASSURE offers insight into radium-223 use in global real-world clinical practice with currently available therapies. At this interim analysis, with a median follow-up of almost 1 year, 1% of patients had second primary malignancies, and safety and overall survival findings were consistent with clinical trial experience. Final analysis of REASSURE is due in 2024. Funding Bayer HealthCare.
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Affiliation(s)
- Celestia S. Higano
- Departments of Medicine and Urology, University of Washington, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Daniel J. George
- Departments of Medicine and Surgery, Duke Cancer Institute, Duke University, Durham, NC, USA
| | - Neal D. Shore
- Carolina Urologic Research Center, Myrtle Beach, SC, USA
| | - Oliver Sartor
- Departments of Medicine and Urology, Tulane Cancer Center, Tulane University School of Medicine, New Orleans, LA, USA
| | - Kurt Miller
- Department of Urology, Charité University Hospital, Berlin, Germany
| | - Peter S. Conti
- Molecular Imaging Center, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Cora N. Sternberg
- Englander Institute for Precision Medicine, Weill Cornell Department of Medicine, Meyer Cancer Center, New York-Presbyterian Hospital, New York, NY, USA
| | - Fred Saad
- Department of Urology, University of Montreal Hospital Center, Montreal, Quebec, Canada
| | - Juan Pablo Sade
- Department of Clinical Oncology, Alexander Fleming Institute, Buenos Aires, Argentina
| | - Joaquim Bellmunt
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Matthew R. Smith
- Genitourinary Oncology Program, Massachusetts General Hospital Cancer Center, Boston, MA, USA
| | | | | | | | - Bertrand Tombal
- Division of Urology, IREC, Cliniques Universitaires Saint Luc, UCLouvain, Brussels, Belgium
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17
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Jahreiß MC, Heemsbergen WD, Janus C, van de Pol M, Dirkx M, Dinmohamed AG, Nout RA, Hoogeman M, Incrocci L, Aben KKH. Impact of Advanced External Beam Radiotherapy on Second Haematological Cancer Risk in Prostate Cancer Survivors. Clin Oncol (R Coll Radiol) 2023; 35:e278-e288. [PMID: 36725405 DOI: 10.1016/j.clon.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 11/08/2022] [Accepted: 01/12/2023] [Indexed: 01/22/2023]
Abstract
AIMS External beam radiotherapy (EBRT) for prostate cancer (PCa) has rapidly advanced over the years. Advanced techniques with altered dose distributions may have an impact on second haematological cancer (SHC) risks. We assessed SHC risk after EBRT for PCa and explored whether this risk has changed over the years. MATERIALS AND METHODS Patients diagnosed with a T1-T3 PCa between 1990 and 2015 were selected from the Netherlands Cancer Registry. Patients treated with EBRT were assigned to EBRT eras based on the date of diagnosis. These eras represented two-dimensional radiotherapy (2D-RT; 1991-1996), three-dimensional conformal radiotherapy (3D-CRT; 1998-2005) or advanced EBRT (2008-2015). Standardised incidence ratios (SIR) and absolute excess risks (AER) were calculated overall and by EBRT era. Sub-hazard ratios (sHRs) were calculated for the comparison of EBRT versus radical prostatectomy and active surveillance. RESULTS PCa patients with EBRT as the primary treatment (n = 37 762) had an increased risk of developing a SHC (SIR = 1.20; 95% confidence interval 1.13-1.28) compared with the Dutch male general population. Estimated risks were highest for the 2D-RT era (SIR = 1.32; 95% confidence interval 1.14-1.67) compared with the 3D-CRT era (SIR = 1.16; 95% confidence interval 1.05-1.27) and the advanced EBRT era (SIR = 1.21; 95% confidence interval 1.07-1.36). AER were limited, with about five to six extra cases per 10 000 person-years. Relative risk analysis (EBRT versus radical prostatectomy/active surveillance) showed significant elevation with EBRT versus active surveillance (sHR = 1.17; 95% confidence interval 1.03-1.33; P = 0.017), but not for EBRT versus radical prostatectomy (sHR = 1.08; 95% confidence interval 0.94-1.23; P = 0.281). CONCLUSION Increased SHC risks after EBRT for PCa cancer were observed for all EBRT eras compared with the general Dutch male population. Excess risks for EBRT versus other PCa treatment groups were found for only EBRT versus active surveillance.
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Affiliation(s)
- M-C Jahreiß
- Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
| | - W D Heemsbergen
- Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - C Janus
- Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - M van de Pol
- Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - M Dirkx
- Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - A G Dinmohamed
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands; Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; Department of Hematology, Amsterdam UMC, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | - R A Nout
- Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - M Hoogeman
- Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - L Incrocci
- Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - K K H Aben
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands; Research Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
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18
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Rathod S, Shinde K, Porlekar J, Choudhari P, Dhavale R, Mahuli D, Tamboli Y, Bhatia M, Haval KP, Al-Sehemi AG, Pannipara M. Computational Exploration of Anti-cancer Potential of Flavonoids against Cyclin-Dependent Kinase 8: An In Silico Molecular Docking and Dynamic Approach. ACS OMEGA 2023; 8:391-409. [PMID: 36643495 PMCID: PMC9835631 DOI: 10.1021/acsomega.2c04837] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
Over the centuries, cancer has been considered one of the significant health threats. It holds the position in the list of deadliest diseases over the globe. In women, breast cancer is the most common among many cancers and is the second most common cancer all over the world, while lung cancer is the first. Cyclin-dependent kinase 8 (CDK8) has been identified as a critical oncogenic driver that is found in breast cancer and associated with tumor progression. Flavonoids were virtually screened against CDK8 using molecular docking, drug-likeness, ADMET prediction, and a molecular dynamics (MD) simulation approach to determine the potential flavonoid structure against CDK8. The results indicated that ZINC000005854718 showed the highest negative binding affinity of -10.7 kcal/mol with the targeted protein and passed all the drug-likeness parameters. Performed molecular dynamics simulation showed that docked complex systems have good conformational stability over 100 ns in different temperatures (298, 300, 305, 310, and 320 K). The comparison between calculated binding free energy via MM/PB(GB)SA methods and binding affinity calculated via molecular docking suggested tight binding of ZINC000005854718 with targeted protein. The results concluded that ZINC000005854718 has drug-like properties with tight and stable binding with the targeted protein.
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Affiliation(s)
- Sanket Rathod
- Department
of Pharmaceutical Chemistry, Bharati Vidyapeeth
College of Pharmacy, Kolhapur 416 013, Maharashtra, India
| | - Ketaki Shinde
- Department
of Quality Assurance Techniques, Poona College of Pharmacy, Bharati Vidyapeeth Deemed University, Pune 411 038, Maharashtra, India
| | - Jaykedar Porlekar
- Department
of Pharmaceutics, Bharati Vidyapeeth College
of Pharmacy, Kolhapur 416 013, Maharashtra, India
| | - Prafulla Choudhari
- Department
of Pharmaceutical Chemistry, Bharati Vidyapeeth
College of Pharmacy, Kolhapur 416 013, Maharashtra, India
| | - Rakesh Dhavale
- Department
of Pharmaceutics, Bharati Vidyapeeth College
of Pharmacy, Kolhapur 416 013, Maharashtra, India
| | - Deepak Mahuli
- Department
of Pharmacology, Bharati Vidyapeeth College
of Pharmacy, Kolhapur 416 013, Maharashtra, India
| | - Yasinalli Tamboli
- Wockhardt
Research Centre, D-4, MIDC, Chikalthana, Aurangabad 431 006, Maharashtra, India
| | - Manish Bhatia
- Department
of Pharmaceutical Chemistry, Bharati Vidyapeeth
College of Pharmacy, Kolhapur 416 013, Maharashtra, India
| | - Kishan P. Haval
- Department
of Chemistry, Dr. Babasaheb Ambedkar Marathwada
University Sub Campus, Osmanabad 413501, Maharashtra, India
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Lin J, Zhan X, Chen R, Chen T, Jiang M, Li Y, Liu X, Chen G, Fu B. Increased Burden of Second Bladder Cancer and Rectal Cancer in Prostate Cancer Treated With Radiotherapy: Results From Surveillance, Epidemiology, and End Results. Cancer Control 2023; 30:10732748231177544. [PMID: 37196346 DOI: 10.1177/10732748231177544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Previous studies have confirmed the higher risk of bladder cancer (BC) and rectal cancer (RC) development among prostate cancer (PCa) patients receiving radiotherapy. In this study, we intend to explore the long-term trend in second BC and RC incidence among PCa patients undergoing radiotherapy. METHOD We identified first primary PCa patients diagnosed between 1975 and 2014 from the Surveillance, Epidemiology, and End Results (SEER)-9 cancer registries. Standardized incidence ratios (SIRs) were calculated by calendar year of diagnosis among PCa patients receiving radiotherapy and not. P trends were evaluated using Poisson regression. 10-year cumulative incidence of BC and RC was calculated utilizing competing risk regression model. RESULT Of PCa patients treated with radiotherapy, SIRs of BC increased from .82 (95% CI: .35- 1.61) in 1980-1984 to 1.58 (95% CI: 1.48-1.68) in 2010-2014 (Ptrend=.003). SIRs of RC increased from 1.01 (95% CI: .27-2.58) in 1980-1984 to 1.54 (95% CI: 1.31-1.81) in 2010-2014 (Ptrend=.025). No statistically significant change in both BC and RC incidence was observed. The 10-year cumulative incidence of BC increased from 1975-1984 (.04%) to 2005-2014 (.15%) among PCa treated with radiotherapy. Simultaneously, the 10-year cumulative incidence of RC was demonstrated to range from 1975-1984 (.02%) to 2005-2014 (.11%). CONCLUSION we have observed an increasing trend in second BC and RC incidence in PCa patients receiving radiotherapy. There was no significant change in the incidence of second BC and RC in PCa without radiotherapy. These results reflect the increasing clinical burden of second malignant tumors in PCa patients undergoing radiotherapy.
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Affiliation(s)
- JinFang Lin
- Department of Urology, The First Hospital of Putian City, Putian, China
| | - Xiangpeng Zhan
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ru Chen
- Department of Urology, The First Hospital of Putian City, Putian, China
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Tao Chen
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ming Jiang
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yi Li
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiaoqiang Liu
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Guoxian Chen
- Department of Urology, The First Hospital of Putian City, Putian, China
| | - Bin Fu
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
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20
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Wang S, Zheng R, Arnold M, Abnet C, Zeng H, Zhang S, Chen R, Sun K, Li L, An L, Bray F, Wei W, He J. Global and national trends in the age-specific sex ratio of esophageal cancer and gastric cancer by subtype. Int J Cancer 2022; 151:1447-1461. [PMID: 35678331 PMCID: PMC9541383 DOI: 10.1002/ijc.34158] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/02/2022] [Accepted: 04/19/2022] [Indexed: 12/11/2022]
Abstract
A male predominance was observed in esophageal and gastric cancers, though present limited data has revealed variations by age. We aim to investigate the global age-specific sex differences in esophageal squamous cell carcinoma (ESCC), esophageal adenocarcinoma (EAC), gastric cardia cancer (GCC) and gastric noncardia cancer (GNCC). Data on esophageal and gastric cancers incidence by diagnosis year, sex, histology, subsite and age group were extracted from 171 registries in 54 countries included in the last two volumes (X and XI, 2003-2012) of Cancer Incidence in Five Continents, which contributing to over 80% of the global burdens of these cancers. Age-standardized incidence rates (ASIRs) and male-to-female ASIRs ratios were estimated for esophageal and gastric cancers, by histological subtype and subsite, globally and by country. We consistently observed a male predominance in esophageal and gastric cancers across the world from 2003 to 2012, with male-to-female ASIRs ratios of 6.7:1 for EAC, 3.3:1 for ESCC, 4.0:1 for GCC and 2.1:1 for GNCC. The sex differences were consistent across time periods but varied significantly by age across the life span. Across the four cancer types, the male-to-female incidence rate ratios increased from young ages, approaching a peak at ages 60-64, but sharply declined thereafter. Similar "low-high-low" trends of age-specific sex ratio were observed in other digestive cancers including liver, pancreas, colon and rectum with peak ages ranging from 50 to 65. Age-dependent risk factors warrant further investigation to aid our understanding of the underlying etiologies of esophageal and gastric cancers by histological subtype and subsite.
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Affiliation(s)
- Shaoming Wang
- National Central Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Rongshou Zheng
- National Central Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Melina Arnold
- Cancer Surveillance BranchInternational Agency for Research on CancerLyonFrance
| | - Christian Abnet
- Metabolic Epidemiology Branch/Division of Cancer Epidemiology & Genetics, National Cancer InstituteNational Institutes of HealthRockvilleMarylandUSA
| | - Hongmei Zeng
- National Central Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Siwei Zhang
- National Central Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Ru Chen
- National Central Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Kexin Sun
- National Central Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Li Li
- National Central Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Lan An
- National Central Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Freddie Bray
- Cancer Surveillance BranchInternational Agency for Research on CancerLyonFrance
| | - Wenqiang Wei
- National Central Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Jie He
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
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21
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Concurrent Androgen Deprivation Therapy for Prostate Cancer Improves Survival for Synchronous or Metachronous Non-Small Cell Lung Cancer: A SEER-Medicare Database Analysis. Cancers (Basel) 2022; 14:cancers14133206. [PMID: 35804979 PMCID: PMC9265064 DOI: 10.3390/cancers14133206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction: The crosstalk between receptor kinase signaling, such as EGFR and androgen receptor signaling, suggests a potential interaction between androgen deprivation therapy (ADT) and lung cancer outcome. Methods: We employed the SEER−Medicare data of lung cancer patients diagnosed between 1988 and 2005 to test for an association between ADT for prostate cancer and lung cancer outcome. We employed the Kaplan−Meier method and Cox proportional hazard with log-rank test model to assess any significant impact of ADT on survival. Results: We included data from 367,750 lung cancer patients; 17.4%, 2.9%, 33.6% and 46.1% with stages I, II, III and IV, respectively; 84.5% were >65 years; 57.2% males; 84.2% Caucasians and 9.3% Blacks. There were 11,061 patients (3%) with an initial prostate cancer diagnosis followed by lung cancer (P-L group); 3017 (0.8%) with an initial diagnosis of lung cancer and subsequent prostate cancer diagnosis (L-P group); the remainder had only lung cancer (L group). Stage I lung cancer was most common in the L-P group compared to the L and P-L groups—54% vs. 17.13% vs. 17.92%, p < 0.0001 for L-P, L and P-L, respectively. The median OS for lung cancer diagnosis was 93 months versus 10 and 9 months, respectively, for the L-P, L and P-L subgroups. ADT was associated with improved survival on multivariate analysis, especially in Caucasian patients (HR of death: 0.86; 95% CI: 0.76−0.97; p = 0.012). Conclusion: ADT was associated with improved outcome for NSCLC, in line with the hypothesis of a role for the androgen receptor in lung cancer. Our findings support a systematic evaluation of the potential benefit of ADT as a therapy for lung cancer.
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22
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Profile of Male Breast Cancer in Makkah Region of Saudi Arabia: A 4-Year Retrospective Analysis of Radiology and Histopathology. Int J Breast Cancer 2022; 2022:8831011. [PMID: 35784659 PMCID: PMC9242822 DOI: 10.1155/2022/8831011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 05/08/2022] [Accepted: 05/26/2022] [Indexed: 11/18/2022] Open
Abstract
Background Mammography is a method widely used for the diagnosis of breast disorders in women and may help detect breast cancer in its early stages. Male breast cancer often remains undiagnosed or is poorly controlled until serious complications arise; therefore, the use of screening methods is needed to help with early diagnosis. Methods From a total of 1,667 registered mammography cases screened, 17 male breast disease cases were included in this study. Mammography and ultrasound data were analyzed by Statistical Package of Social Sciences v.22 (SPSS). Diagnosis was made following biopsy in suspicious cases, and histopathological and immunological findings of all such patients were obtained for final diagnosis. Results The mean age of the patients was 35 years (range, 14-70 years); 17.6% of the cases were aged 37 yrs, and 2 cases were aged 51 and 52 yrs. Of the 17 cases, 11 had breast lesions, and skin thickening was observed in only 1 case. The different patterns of lesions detected were asymmetry of the parenchyma, mastitis, and hamartoma (n = 1 each), malignant lesions (n = 2), and gynecomastia (n = 6). According to the BI-RADS categorization, 8 cases were benign, one case was probably benign, and 2 cases were likely malignant. In the 2 cases with malignant lesions, pathological diagnosis was made after hematoxylin and eosin and immunocytochemistry examination as invasive ductal carcinoma (IDC) of no special type (NST), grade II and grade III. Conclusions Most breast lesions in this study population were benign, while IDC was the most common malignancy encountered. Mammography is currently the most accurate and cost-effective method for detecting breast lesions. The findings of our study may help increase awareness of male breast cancer and encourage Saudi men at risk to perform self-breast exam and undergo routine breast screening.
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Song Y, Du Y, Xu T. Re: Jiatong Zhou, Jie Ding, Jun Qi. Comparison of Typical Prostate Adenocarcinoma and Rare Histological Variant Prostate Cancer Showed Different Characteristics and Prognosis: A Surveillance, Epidemiology, and End Results Database Analysis. Eur Urol. In press. https://doi.org/10.1016/j.eururo.2022.02.006. Eur Urol 2022; 82:e47-e48. [DOI: 10.1016/j.eururo.2022.04.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 04/05/2022] [Indexed: 11/27/2022]
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24
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Yu W, Guo J. Racial/ethnic disparities in survival of metastatic prostate cancer patients treated with external beam radiotherapy. World J Urol 2022; 40:1065. [PMID: 34664105 DOI: 10.1007/s00345-021-03859-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 10/05/2021] [Indexed: 12/13/2022] Open
Affiliation(s)
- Wenxiao Yu
- Department of Andrology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
| | - Jun Guo
- Department of Andrology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China.
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25
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Wu YY, Fan KH. Proton therapy for prostate cancer: current state and future perspectives. Br J Radiol 2022; 95:20210670. [PMID: 34558308 PMCID: PMC8978248 DOI: 10.1259/bjr.20210670] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Localized prostate cancer can be treated with several radiotherapeutic approaches. Proton therapy (PT) can precisely target tumors, thus sparing normal tissues and reducing side-effects without sacrificing cancer control. However, PT is a costly treatment compared with conventional photon radiotherapy, which may undermine its overall efficacy. In this review, we summarize current data on the dosimetric rationale, clinical benefits, and cost of PT for prostate cancer. METHODS An extensive literature review of PT for prostate cancer was performed with emphasis on studies investigating dosimetric advantage, clinical outcomes, cost-effective strategies, and novel technology trends. RESULTS PT is safe, and its efficacy is comparable to that of standard photon-based therapy or brachytherapy. Data on gastrointestinal, genitourinary, and sexual function toxicity profiles are conflicting; however, PT is associated with a low risk of second cancer and has no effects on testosterone levels. Regarding cost-effectiveness, PT is suboptimal, although evolving trends in radiation delivery and construction of PT centers may help reduce the cost. CONCLUSION PT has several advantages over conventional photon radiotherapy, and novel approaches may increase its efficacy and safety. Large prospective randomized trials comparing photon therapy with proton-based treatments are ongoing and may provide data on the differences in efficacy, toxicity profile, and quality of life between proton- and photon-based treatments for prostate cancer in the modern era. ADVANCES IN KNOWLEDGE PT provides excellent physical advantages and has a superior dose profile compared with X-ray radiotherapy. Further evidence from clinical trials and research studies will clarify the role of PT in the treatment of prostate cancer, and facilitate the implementation of PT in a more accessible, affordable, efficient, and safe way.
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Affiliation(s)
- Yao-Yu Wu
- Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan
| | - Kang-Hsing Fan
- Department of Radiation Oncology, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
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26
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Poon DMC, Wu S, Ho L, Cheung KY, Yu B. Proton Therapy for Prostate Cancer: Challenges and Opportunities. Cancers (Basel) 2022; 14:cancers14040925. [PMID: 35205673 PMCID: PMC8870339 DOI: 10.3390/cancers14040925] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/10/2022] [Accepted: 02/11/2022] [Indexed: 01/02/2023] Open
Abstract
Simple Summary Reported clinical outcomes of proton therapy (PT) for localized prostate cancer are similar to photon-based external beam radiotherapy. Apparently, the dosimetric advantages of PT have yet to be translated to clinical benefits. The suboptimal clinical outcomes of PT might be attributable to inadequate dose prescription, as indicated by the ASCENDE-RT trial. Moreover, uncertainties involved in the treatment planning and delivery processes, as well as technological limitations in PT treatment systems, may lead to discrepancies between planned doses and actual doses delivered to patients. In this article, we reviewed the current status of PT for prostate cancer and discussed different clinical implementations that could potentially improve the clinical outcome of PT for prostate cancer. Various technological advancements under which uncertainties in dose calculations can be minimized, including MRI-guided PT, dual-energy photon-counting CT and high-resolution Monte Carlo-based treatment planning systems, are highlighted. Abstract The dosimetric advantages of proton therapy (PT) treatment plans are demonstrably superior to photon-based external beam radiotherapy (EBRT) for localized prostate cancer, but the reported clinical outcomes are similar. This may be due to inadequate dose prescription, especially in high-risk disease, as indicated by the ASCENDE-RT trial. Alternatively, the lack of clinical benefits with PT may be attributable to improper dose delivery, mainly due to geometric and dosimetric uncertainties during treatment planning, as well as delivery procedures that compromise the dose conformity of treatments. Advanced high-precision PT technologies, and treatment planning and beam delivery techniques are being developed to address these uncertainties. For instance, external magnetic resonance imaging (MRI)-guided patient setup rooms are being developed to improve the accuracy of patient positioning for treatment. In-room MRI-guided patient positioning systems are also being investigated to improve the geometric accuracy of PT. Soon, high-dose rate beam delivery systems will shorten beam delivery time to within one breath hold, minimizing the effects of organ motion and patient movements. Dual-energy photon-counting computed tomography and high-resolution Monte Carlo-based treatment planning systems are available to minimize uncertainties in dose planning calculations. Advanced in-room treatment verification tools such as prompt gamma detector systems will be used to verify the depth of PT. Clinical implementation of these new technologies is expected to improve the accuracy and dose conformity of PT in the treatment of localized prostate cancers, and lead to better clinical outcomes. Improvement in dose conformity may also facilitate dose escalation, improving local control and implementation of hypofractionation treatment schemes to improve patient throughput and make PT more cost effective.
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Affiliation(s)
- Darren M. C. Poon
- Comprehensive Oncology Centre, Hong Kong Sanatorium & Hospital, Hong Kong 999077, China;
| | - Stephen Wu
- Medical Physics Department, Hong Kong Sanatorium & Hospital, Hong Kong 999077, China; (L.H.); (K.Y.C.); (B.Y.)
- Correspondence: ; Tel.: +852-29171413
| | - Leon Ho
- Medical Physics Department, Hong Kong Sanatorium & Hospital, Hong Kong 999077, China; (L.H.); (K.Y.C.); (B.Y.)
| | - Kin Yin Cheung
- Medical Physics Department, Hong Kong Sanatorium & Hospital, Hong Kong 999077, China; (L.H.); (K.Y.C.); (B.Y.)
| | - Ben Yu
- Medical Physics Department, Hong Kong Sanatorium & Hospital, Hong Kong 999077, China; (L.H.); (K.Y.C.); (B.Y.)
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27
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Wu Y, Li Y, Han C, Chong Y, Kang K, Liu Z, Zhang F. Risk of second primary malignancies associated with radiotherapy in prostate cancer patients: competing risk analysis. Future Oncol 2022; 18:445-455. [PMID: 35018785 DOI: 10.2217/fon-2021-0332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: The effect of radiotherapy (RT) for second primary malignancies (SPMs) among prostate cancer survivors is controversial. Methods: Applying logistic regression, competing risk analysis and propensity score matching method, this study analyzed clinical data from the Surveillance, Epidemiology, and End Results program to compare the risk for SPMs between patients receiving RT and non-RT. Results: In this study, prostate cancer patients treated with RT developed more SPMs in the anus, bladder, rectum, liver, lung and bronchus and lymphoma than non-RT groups. Conclusion: More intensive surveillance should be adopted for these cancers among prostate cancer survivors.
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Affiliation(s)
- Yijun Wu
- Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China.,Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Yunlong Li
- Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Chang Han
- Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Yuming Chong
- Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Kai Kang
- Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China.,Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Zhikai Liu
- Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China
| | - Fuquan Zhang
- Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China
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Kosaka T, Iizuka S, Yoneda T, Otsuki Y, Nakamura T. Solitary pulmonary nodule as the initial manifestation of isolated metastasis from prostate cancer without bone involvement: A case report. Int J Surg Case Rep 2022; 90:106681. [PMID: 34953424 PMCID: PMC8715057 DOI: 10.1016/j.ijscr.2021.106681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 12/07/2021] [Indexed: 12/04/2022] Open
Abstract
Introduction Isolated lung metastases from prostate cancer without any other organ involvement are rare. They are commonly in the form of diffuse or multiple lesions and rarely emerge as a solitary pulmonary nodule. Presentation of case A 61-year-old man who had undergone a laparoscopic-assisted radical prostatectomy for prostate cancer 16 months prior presented with a growing solitary pulmonary nodule. Positron emission tomography/computed tomography showed an abnormal uptake in the nodule without any other organ involvement. A surgical specimen by a thoracoscopic wedge resection proved a diagnosis of a metastasis from prostate cancer. He is currently alive only with worsening pulmonary metastases at 7 years after the lung surgery. Discussion A rare entity of isolated pulmonary metastases could be a sole finding of metastatic prostate cancer over the years and its initial manifestation could emerge as a solitary pulmonary nodule. It poses a diagnostic challenge because primary lung cancer is the leading differential diagnosis of solitary pulmonary nodules and is also one of the most frequent second primary malignancies in prostate cancer survivors. Conclusion An aggressive surgical biopsy is essential for definitive histopathological and immunohistochemical analyses of solitary pulmonary nodules to distinguish a rare form of an isolated pulmonary relapse from a second primary lung cancer in prostate cancer survivors. Isolated pulmonary metastasis without bone involvement from prostate cancer may rarely emerge as a solitary pulmonary nodule. Primary lung cancer is a leading differential diagnosis of solitary pulmonary nodules in general and is also one of the most frequent second primary malignancies in prostate cancer survivors. A surgical lung biopsy is a feasible option for a definitive histoimmunological diagnosis of solitary pulmonary nodules to distinguish a rare form of an isolated pulmonary metastasis from a second primary lung cancer in prostate cancer survivors.
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Affiliation(s)
- Tatsuaki Kosaka
- Department of General Thoracic Surgery, Seirei Hamamatsu General Hospital, 2-12-12, Sumiyoshi, Naka-ku, Hamamatsu-city, Shizuoka 430-8558, Japan.
| | - Shuhei Iizuka
- Department of General Thoracic Surgery, Seirei Hamamatsu General Hospital, 2-12-12, Sumiyoshi, Naka-ku, Hamamatsu-city, Shizuoka 430-8558, Japan.
| | - Tatsuaki Yoneda
- Department of Urology, Seirei Hamamatsu General Hospital, 2-12-12, Sumiyoshi, Naka-ku, Hamamatsu-city, Shizuoka 430-8558, Japan.
| | - Yoshiro Otsuki
- Department of Pathology, Seirei Hamamatsu General Hospital, 2-12-12, Sumiyoshi, Naka-ku, Hamamatsu-city, Shizuoka 430-8558, Japan.
| | - Toru Nakamura
- Department of General Thoracic Surgery, Seirei Hamamatsu General Hospital, 2-12-12, Sumiyoshi, Naka-ku, Hamamatsu-city, Shizuoka 430-8558, Japan.
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Sharma N, Mandal S, Gupta S, Baishya P, Lekshmi R, Namitha RS, Gupta M. Case report of metachronous pleural mesothelioma with carcinoma prostate: Diagnostic dilemma. CANCER RESEARCH, STATISTICS, AND TREATMENT 2022. [DOI: 10.4103/crst.crst_249_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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30
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Jahreiß MC, Heemsbergen WD, van Santvoort B, Hoogeman M, Dirkx M, Pos FJ, Janssen T, Dekker A, Vanneste B, Minken A, Hoekstra C, Smeenk RJ, van Oort IM, Bangma CH, Incrocci L, Aben KKH. Impact of Advanced Radiotherapy on Second Primary Cancer Risk in Prostate Cancer Survivors: A Nationwide Cohort Study. Front Oncol 2021; 11:771956. [PMID: 34900722 PMCID: PMC8662556 DOI: 10.3389/fonc.2021.771956] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 11/08/2021] [Indexed: 12/30/2022] Open
Abstract
Purpose External Beam Radiotherapy (EBRT) techniques dramatically changed over the years. This may have affected the risk of radiation-induced second primary cancers (SPC), due to increased irradiated low dose volumes and scatter radiation. We investigated whether patterns of SPC after EBRT have changed over the years in prostate cancer (PCa) survivors. Materials and Methods PCa survivors diagnosed between 1990-2014 were selected from the Netherlands Cancer Registry. Patients treated with EBRT were divided in three time periods, representing 2-dimensional Radiotherapy (RT), 3-dimensional conformal RT (3D-CRT), and the advanced RT (AdvRT) era. Standardized incidence ratios (SIR) and absolute excess risks (AER) were calculated to estimate relative and excess absolute SPC risks. Sub-hazard ratios (sHRs) were calculated to compare SPC rates between the EBRT and prostatectomy cohort. SPCs were categorized by subsite and anatomic region. Results PCa survivors who received EBRT had an increased risk of developing a solid SPC (SIR=1.08; 1.05-1.11), especially in patients aged <70 years (SIR=1.13; 1.09-1.16). Pelvic SPC risks were increased (SIR=1.28; 1.23-1.34), with no obvious differences between the three EBRT eras. Non-pelvic SPC were only significantly increased in the AdvRT era (SIR=1.08; 1.02-1.14), in particular for the 1-5 year follow-up period. Comparing the EBRT cohort to the prostatectomy cohort, again an increased pelvic SPC risk was found for all EBRT periods (sHRs= 1.61, 1.47-1.76). Increased non-pelvic SPC risks were present for all RT eras and highest for the AdvRT period (sHRs=1.17, 1.06-1.29). Conclusion SPC risk in patients with EBRT is increased and remained throughout the different EBRT eras. The risk of developing a SPC outside the pelvic area changed unfavorably in the AdvRT era. Prolonged follow-up is needed to confirm this observation. Whether this is associated with increased irradiated low-dose volumes and scatter, or other changes in clinical EBRT practice, is the subject of further research.
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Affiliation(s)
| | - Wilma D Heemsbergen
- Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Bo van Santvoort
- Department of Research, Netherlands Comprehensive Cancer Organization, Utrecht, Netherlands
| | - Mischa Hoogeman
- Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Maarten Dirkx
- Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Floris J Pos
- The Netherlands Cancer Institute, Radiation Oncology, Amsterdam, Netherlands
| | - Tomas Janssen
- The Netherlands Cancer Institute, Radiation Oncology, Amsterdam, Netherlands
| | - Andre Dekker
- Department of Radiation Oncology (Maastro), GROW Institute for Oncology and Developmental Biology, Maastricht, Netherlands
| | - Ben Vanneste
- Department of Radiation Oncology (Maastro), GROW Institute for Oncology and Developmental Biology, Maastricht, Netherlands
| | - Andre Minken
- Department of Radiation Oncology, Radiotherapiegroep, Deventer, Netherlands
| | - Carel Hoekstra
- Department of Radiation Oncology, Radiotherapiegroep, Deventer, Netherlands
| | - Robert J Smeenk
- Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Inge M van Oort
- Department of Urology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Chris H Bangma
- Department of Urology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Luca Incrocci
- Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Katja K H Aben
- Department of Research, Netherlands Comprehensive Cancer Organization, Utrecht, Netherlands.,Research Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
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Guo L, Fu Y, Miao C, Wu S, Zhu Y, Liu Y. Second Primary Malignancy in Patients with Hypopharyngeal Carcinoma: A SEER-Based Study. Int J Gen Med 2021; 14:8847-8861. [PMID: 34858052 PMCID: PMC8630468 DOI: 10.2147/ijgm.s339595] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 11/04/2021] [Indexed: 12/19/2022] Open
Abstract
Background A population-based analysis of the risk of secondary primary malignancy (SPM) in patients with hypopharyngeal carcinoma (HPC) has been lacking in the literature. Therefore, we conducted this study to determine the risk factors and assess the effects of SPM on the overall survival (OS) and cancer-specific survival (CSS) of patients with HPC. Methods Data on selected patients diagnosed with HPC from the Surveillance, Epidemiology and End Results (SEER) database between 1973 and 2015 were examined through logistic regression, Cox regression and nomogram methods. Results The overall risk of SPM in patients with HPC was higher than that in the general population (SIR: 2.77; P < 0.05). The specific-site, including the oral cavity, pharynx, digestive system, respiratory system and endocrine system, had a relatively higher risk of SPM. The overall risks of the subgroup of people 55–75 years of age and all subgroups of sex, race and latency were significantly elevated. In addition, patients with HPC were more likely to have been diagnosed in 2010–2015 (vs 2004–2009; P = 0.002), to be unmarried (vs married; P = 0.008), to have distant metastasis (vs no metastasis; P = 0.016) and to have had no surgery for the first tumor (vs surgery for the first tumor; P = 0.021), and these aspects were associated with a significantly elevated risk of developing SPM. SPM was independently associated with better OS and CSS. The OS and CSS in patients with HPC with SPM were better than those in patients without SPM (log rank P < 0.0001). The C indexes of the nomogram constructed with ten influencing factors including SPM were 0.681:0.699 for OS and 0.705:0.724 for CSS (training cohort:validation cohort). Conclusion Although the overall risk of SPM in patients with HPC was elevated, SPM did not decrease the OS and CSS in patients with HPC. This finding is inconsistent with clinical observations and thus requires further research and exploration. It possibly because HPC might have a shorter survival time, or the follow-up time was not long enough.
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Affiliation(s)
- Liqing Guo
- Department of Otolaryngology, The Second Affiliated Hospital of Nanchang University, NanChang, 330006, JiangXi, People's Republic of China
| | - Yanpeng Fu
- Department of Otolaryngology, The Second Affiliated Hospital of Nanchang University, NanChang, 330006, JiangXi, People's Republic of China
| | - Chunyu Miao
- Department of Otolaryngology, Nanchang Affiliated Hospital of Sun Yat-Sen University, NanChang, 330009, JiangXi, People's Republic of China
| | - Shuhong Wu
- Department of Otolaryngology, The Second Affiliated Hospital of Nanchang University, NanChang, 330006, JiangXi, People's Republic of China
| | - Yaqiong Zhu
- Department of Otolaryngology, The Second Affiliated Hospital of Nanchang University, NanChang, 330006, JiangXi, People's Republic of China
| | - Yuehui Liu
- Department of Otolaryngology, The Second Affiliated Hospital of Nanchang University, NanChang, 330006, JiangXi, People's Republic of China
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Bidoli E, Lamaj E, Angelin T, Forgiarini O, De Santis E, Serraino D. Linearity of Age at Cancer Onset Worldwide: 25-Year Population-Based Cancer Registry Study. Cancers (Basel) 2021; 13:5589. [PMID: 34771751 PMCID: PMC8583131 DOI: 10.3390/cancers13215589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 10/29/2021] [Accepted: 11/03/2021] [Indexed: 11/16/2022] Open
Abstract
Background The linear association between median age at cancer onset and median age of the underlying population has been described only for breast cancer. We quantified the shape and strength of such association for 20 cancer types using data from all population-based cancer registries (CRs) worldwide. Methods The patients' median age at cancer onset and of the underlying population were extracted from all CRs listed in volumes VI (1983-1987 years) and XI (2008-2012 years) of Cancer Incidence in Five Continents. The association was assessed at cross-sectional level by linear regression models and longitudinally considering only the long-standing CRs active throughout the study period (i.e., 25-year span). Results During 2008-2012, each one-year increase in median population ageing was associated in men with a nearly half year increase of median age at onset of all cancers, but skin; and a 2/3 year increase in women. Variance explained by linear model was around 60%. In long-standing CRs a decrease in median age at cancer onset was observed for prostate and cervical cancers throughout the 25-year span. Conclusions Population ageing reflected 60% of the median age at cancer onset. Misinterpretation of peaks of cancer incidence in specific age groups may be avoided by examining population pyramids.
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Affiliation(s)
- Ettore Bidoli
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, via Gallini 2, 33081 Aviano, Italy; (T.A.); (D.S.)
| | - Elda Lamaj
- Friuli Venezia Giulia Cancer Registry, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, via Gallini 2, 33081 Aviano, Italy; (E.L.); (O.F.); (E.D.S.)
| | - Tiziana Angelin
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, via Gallini 2, 33081 Aviano, Italy; (T.A.); (D.S.)
| | - Ornella Forgiarini
- Friuli Venezia Giulia Cancer Registry, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, via Gallini 2, 33081 Aviano, Italy; (E.L.); (O.F.); (E.D.S.)
| | - Emilia De Santis
- Friuli Venezia Giulia Cancer Registry, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, via Gallini 2, 33081 Aviano, Italy; (E.L.); (O.F.); (E.D.S.)
| | - Diego Serraino
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, via Gallini 2, 33081 Aviano, Italy; (T.A.); (D.S.)
- Friuli Venezia Giulia Cancer Registry, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, via Gallini 2, 33081 Aviano, Italy; (E.L.); (O.F.); (E.D.S.)
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Hussain Z, Khan J, Saeed A, Dihowm F. Occurrence of Second Primary Malignancies in Patients With Primary Optic Nerve Gliomas: A Surveillance, Epidemiology, and End Results Analysis. CANCER DIAGNOSIS & PROGNOSIS 2021; 1:393-398. [PMID: 35403153 PMCID: PMC8962871 DOI: 10.21873/cdp.10052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/13/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND/AIM Advanced understanding of screening and therapeutic modalities acts as provision for increased survival in patients diagnosed with optic nerve gliomas. Secondary primary malignancies (SPMs) in patients diagnosed with primary optic nerve glioma (OPG) are currently an uncharacterized frontier. This US national database analysis highlights the incidences of SPMs in patients diagnosed with primary OPG. MATERIALS AND METHODS Standardized incidence ratios (SIR) and excess absolute risk (EAR) for SPMs were calculated using the SEER-specific multiple outcome analysis. 95% SIR confidence intervals were calculated with statistical significance achieved at p<0.05. RESULTS SPMs originating from soft tissues (including the heart) (SIR=33.23, CI=6.85-97.11; EAR=5.07), breast (SIR=4.99, CI=1.36-12.77; EAR=5.57), female breast (SIR=5.03, CI=1.37-12.89; EAR=5.58), brain (SIR=105.38, CI=65.23-161.08; EAR=36.23), cranial nerves (SIR=103.29, CI=12.51-373.12; EAR=3.45), non-lymphocytic leukemia (SIR=15.05, CI=1.82-54.37; EAR=3.25), myeloid and monocytic leukemia (SIR=16.26, CI=1.97-58.75; EAR=3.27), and Kaposi's sarcoma (SIR=79.88, CI=2.02-445.08; EAR=1.72) demonstrated significantly increased SIR. Overall, the values for cumulative SPM (SIR=6.04, CI=4.33-8.19; EAR=59.60) highlight the overall significance in incidence of SPM in patients diagnosed with OPG. CONCLUSION Clinical decision-making should reconcile enhanced propensities for development of SPM.
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Affiliation(s)
- Zain Hussain
- University of Medicine and Health Sciences, Portland, ME, U.S.A
| | - Jawad Khan
- Texas Tech University Health Sciences Center - Paul L. Foster School of Medicine, El Paso, TX, U.S.A
| | - Amir Saeed
- Texas Tech University Health Sciences Center - Paul L. Foster School of Medicine, El Paso, TX, U.S.A
| | - Fatma Dihowm
- Texas Tech University Health Sciences Center - Paul L. Foster School of Medicine, El Paso, TX, U.S.A
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Zhang H, Yu A, Baran A, Messing E. Risk of second cancer among young prostate cancer survivors. Radiat Oncol J 2021; 39:91-98. [PMID: 34619825 PMCID: PMC8497857 DOI: 10.3857/roj.2020.00857] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 04/12/2021] [Indexed: 01/19/2023] Open
Abstract
Purpose About 40% of men diagnosed with prostate cancer (Pca) are ≤65 years of age. This study evaluates the risk of second cancer among young Pca patients treated with surgery or radiation. Materials and Methods This is a retrospective review of 150,915 men aged ≤65 years at Pca diagnosis treated with surgery or radiation registered in the Surveillance, Epidemiology, and End Results (SEER) database between 1973 and 2014. Incidence rates of second rectum/rectosigmoid junction (RJ), bladder, and lung cancer in each treatment group were reported with adjustment for potential confounders. Cumulative incidence functions were used to summarize the risk of second cancer after completing initial treatment. Results Men treated with external beam radiation (BEAM), brachytherapy (SEED), or combined radiation all exhibited a statistically significant increased incidence of second bladder cancer compared to men treated with surgery (adjusted incidence rate ratio [IRR]: 2.09, 1.91, and 2.04, respectively). Incidence of rectum/RJ cancer was also significantly increased in men receiving BEAM and combined radiation (adjusted IRR: 1.58 and 1.98, respectively). There were also significant differences in the cumulative incidence of second bladder cancer after receiving any form of radiation compared to surgery. Conclusion Pca survivors ≤65 years of age at Pca diagnosis had an increased risk of second bladder and rectum/RJ cancer after BEAM and combined radiation treatment after adjusting for confounding factors. Second bladder cancer incidence after either form of radiation treatment was increased even at 5 years after a Pca diagnosis.
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Affiliation(s)
- Hong Zhang
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY, USA
| | - Andrew Yu
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Andrea Baran
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Edward Messing
- Department of Urology, University of Rochester Medical Center, Rochester, NY, USA
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35
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Zhang L, Hsieh MC, Allison C, Devane M, Hicks C, Yu Q, Shi L, Wu J, Wu XC. Racial differences in the risk of second primary bladder cancer following radiation therapy among localized prostate cancer patients. Cancer Epidemiol 2021; 73:101967. [PMID: 34146916 PMCID: PMC8357014 DOI: 10.1016/j.canep.2021.101967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 06/03/2021] [Accepted: 06/07/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To investigate the race-specific second primary bladder cancer (SPBC) risk following prostatic irradiation. METHODS Louisiana residents who were diagnosed with localized prostate cancer (PCa) in 1996-2013 and received surgery or radiation were included. Patients were followed until SPBC diagnosis, death, or Dec. 2018. The exposure variable was type of treatment (radiation only vs. surgery only). The outcome was time from PCa diagnosis to SPBC diagnosis, stratified by race. Fine and Gray's competing risk model was applied with death as a competing event and adjustment of sociodemographic and tumor characteristics. We used 5 years and 10 years as lag time in the analyses. RESULTS A total of 26,277 PCa patients with a median follow-up of 10.7 years were analyzed, including 18,598 white and 7679 black patients. About 42.9 % of whites and 45.7 % of blacks received radiation. SPBC counted for 1.84 % in the radiation group and 0.90 % in the surgery group among white patients and for 0.91 % and 0.58 %, respectively, among black patients. The adjusted subdistribution hazard ratio of SPBC was 1.80 (95 % CI: 1.30-2.48) for radiation recipients compared to surgery recipients among white patients; 1.93 (95 % CI: 1.36-2.74) if restricted to external beam radiation therapy (EBRT). The SPBC risk was not significantly different between irradiated and surgically treated among blacks. CONCLUSIONS The SPBC risk is almost two-fold among white irradiated PCa patients compared to their counterparts treated surgically. Our findings highlight the need for enhanced surveillance for white PCa survivors receiving radiotherapy, especially those received EBRT.
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Affiliation(s)
- Lu Zhang
- Department of Public Health Sciences, Clemson University, United States.
| | - Mei-Chin Hsieh
- Epidemiology Program, School of Public Health Sciences, Louisiana State University Health Sciences Center, United States; Louisiana Tumor Registry, School of Public Health Sciences, Louisiana State University Health Sciences Center, United States
| | - Claire Allison
- Department of Public Health Sciences, Clemson University, United States
| | - Michael Devane
- Department of Radiology, Prisma Health, United States; Clemson University School of Health Research, United States
| | - Chindo Hicks
- Department of Genetics, School of Medicine, Louisiana State University Health Sciences Center, United States
| | - Qingzhao Yu
- Biostatistics Program, School of Public Health Sciences, Louisiana State University Health Sciences Center, United States
| | - Lu Shi
- Department of Public Health Sciences, Clemson University, United States
| | - Jiande Wu
- Department of Genetics, School of Medicine, Louisiana State University Health Sciences Center, United States
| | - Xiao-Cheng Wu
- Epidemiology Program, School of Public Health Sciences, Louisiana State University Health Sciences Center, United States; Louisiana Tumor Registry, School of Public Health Sciences, Louisiana State University Health Sciences Center, United States
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Hasbullah HH, MdYusof FW, Ahmad AH, Alzallal O, T Sharif SET. Metastatic Prostate Cancer Synchronous with Male Breast Papillary Ductal Carcinoma in situ: Management Dilemma and Literature Review. Case Rep Oncol 2021; 14:784-791. [PMID: 34177531 PMCID: PMC8215967 DOI: 10.1159/000515784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 03/05/2021] [Indexed: 12/20/2022] Open
Abstract
Prostate cancer is common in men, but tumour of the male breast is rare. For these two tumours to be presented synchronously in a male patient is even rarer. The focus of this paper is the case of a 72-year-old man diagnosed with papillary ductal carcinoma in situ after he presented with a unilateral breast mass associated with nipple discharge. Imaging staging for his breast tumour and subsequent prostate biopsy found an incidental synchronous asymptomatic prostate adenocarcinoma as well as bone metastases. He denies risk factors for malignancies and refuses genetic testing. The first part of our discussion will highlight the uncommon occurrence of male breast ductal carcinoma in situ and its management controversies. The subsequent part of our discussion will focus on the association between male breast cancer and prostate cancer, and implication of this on the future treatment of these patients. More importantly, our case will illustrate the challenges in managing dual primaries that present concurrently.
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Affiliation(s)
- Harissa Husainy Hasbullah
- Clinical Oncologist, Faculty of Medicine, University Teknologi MARA (UiTM), Sungai Buloh, Malaysia.,Visiting Clinical Oncologist, Nuclear Medicine, Radiotherapy and Oncology Department, Hospital Universiti Sains Malaysia (HUSM), Kota Bharu, Malaysia
| | - Farah Wahida MdYusof
- Nuclear Medicine, Radiotherapy and Oncology Department, Hospital Universiti Sains Malaysia (HUSM), Kota Bharu, Malaysia
| | - Amirah Hayati Ahmad
- Nuclear Medicine, Radiotherapy and Oncology Department, Hospital Universiti Sains Malaysia (HUSM), Kota Bharu, Malaysia
| | - Omar Alzallal
- Pathology Department, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Hospital Universiti Sains Malaysia (HUSM), Kota Bharu, Malaysia
| | - Sharifah Emilia T T Sharif
- Pathology Department, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Hospital Universiti Sains Malaysia (HUSM), Kota Bharu, Malaysia
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Zhu Z, Chen Y, Ren J, Dawsey SM, Yin J, Freedman ND, Fan JH, Taylor PR, Liu Y, Qiao YL, Abnet CC. Serum Levels of Androgens, Estrogens, and Sex Hormone Binding Globulin and Risk of Primary Gastric Cancer in Chinese Men: A Nested Case-Control Study. Cancer Prev Res (Phila) 2021; 14:659-666. [PMID: 33766833 PMCID: PMC8225565 DOI: 10.1158/1940-6207.capr-20-0497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/20/2021] [Accepted: 03/22/2021] [Indexed: 12/24/2022]
Abstract
Gastric cancer shows a strong male predominance, and sex steroid hormones have been hypothesized to explain this sex disparity. Previous studies examining the associations between sex hormones and sex hormone binding globulin (SHBG) and risk of gastric cancer come primarily from western populations and additional studies in diverse populations will help us better understand the association. We performed a nested case-control study in Linxian Nutrition Intervention Trials cohorts to evaluate the associations among Chinese men, where we had sufficient cases to perform a well-powered study. Using radioimmunoassays and immunoassays, we quantitated androgens, estrogens, and SHBG in baseline serum from 328 men that developed noncardia gastric cancer and matched controls. We used multivariable unconditional logistic regression to calculate ORs and 95% confidence intervals (CI) and explored interactions with body mass index (BMI), age, alcohol drinking, smoking, and follow-up time. Subjects with SHBG in the highest quartile, as compared with those in the lowest quartile, had a significantly increased risk of gastric cancer (OR = 1.87; 95% CI, 1.01-3.44). We found some evidence for associations of sex steroid hormones in men with lower BMI. Our study found a novel association suggesting that higher serum concentrations of SHBG may be associated with risk of gastric cancer in men. We found no overall associations with sex hormones themselves, but future studies should expand the scope of these studies to include women and further explore whether BMI modifies a potential association. PREVENTION RELEVANCE: It was the first study to investigate the association of gastric cancer with prediagnostic sex steroid hormones and SHBG in an Asian male population. Although there were no overall associations for sex steroid hormone concentrations, higher concentrations of SHBG was associated with increased risk of noncardia gastric cancer.
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Affiliation(s)
- Zhikai Zhu
- Department of Cancer Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yingxi Chen
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Jiansong Ren
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Sanford M Dawsey
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Jian Yin
- Department of Cancer Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Neal D Freedman
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Jin-Hu Fan
- Department of Cancer Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Philip R Taylor
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - You-Lin Qiao
- Department of Cancer Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Christian C Abnet
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
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Nakamura Y, Soma T, Izumi K, Sakai Y, Ushijima H, Kudo S, Saito Y, Kageyama Y. Screening of chronic radiation proctitis and colorectal cancer using periodic total colonoscopy after external beam radiation therapy for prostate cancer. Jpn J Clin Oncol 2021; 51:1298-1302. [PMID: 33889961 DOI: 10.1093/jjco/hyab056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 04/04/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To investigate the incidence of colorectal cancer and chronic radiation proctitis after prostate radiotherapy using periodic total colonoscopy screening. METHODS From February 2013 to January 2018, 270 patients who underwent external beam radiation therapy for prostate cancer were advised to receive periodic total colonoscopy screening annually. We evaluated the incidence and characteristics of colorectal cancer and chronic radiation proctitis. RESULTS First, second, third, fourth and fifth total colonoscopy were performed in 256 (95%), 151 (56%), 60 (22%), 23 (8.5%) and 7 (2.6%) patients at a median of 14, 31, 42, 54 and 72 months after radiotherapy, respectively. The prevalence proportion of colorectal cancer in the first colonoscopy since radiotherapy was 3.9%. Twelve (4.4%) patients were diagnosed with colorectal cancer, including four invasive cancers, during a follow-up period. Eight of these 12 patients had not experienced rectal bleeding. The median time to diagnosis of colorectal cancer was 21 months. Chronic radiation proctitis was observed in 136 (50%) patients, including 67 (25%) patients with symptomatic bleeding. CONCLUSIONS The high detection rate of asymptomatic radiation proctitis suggests the utility of total colonoscopy to screen for early-stage colorectal cancer prior to or following radiotherapy for prostate cancer. Considering the longevity after localized prostate cancer treatment, the awareness of chronic radiation-induced proctitis and the risk of colorectal cancer masked by bleeding is needed in treatment decision -making.
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Affiliation(s)
- Yuki Nakamura
- Department of Urology, Saitama Cancer Center, Saitama, Japan
| | - Takahiko Soma
- Department of Urology, Saitama Cancer Center, Saitama, Japan
| | - Keita Izumi
- Department of Urology, Saitama Cancer Center, Saitama, Japan
| | - Yasuyuki Sakai
- Department of Urology, Saitama Cancer Center, Saitama, Japan
| | - Hiroki Ushijima
- Department of Radiation Oncology, Saitama Cancer Center, Saitama, Japan
| | - Shigehiro Kudo
- Department of Radiation Oncology, Saitama Cancer Center, Saitama, Japan
| | - Yoshihiro Saito
- Department of Radiation Oncology, Saitama Cancer Center, Saitama, Japan
| | - Yukio Kageyama
- Department of Urology, Saitama Cancer Center, Saitama, Japan
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Colorectal Cancer Screening and Surveillance for Non-Hereditary High-Risk Groups—Is It Time for a Re-Think? CURRENT TREATMENT OPTIONS IN GASTROENTEROLOGY 2021; 19:48-67. [PMID: 33424223 PMCID: PMC7781649 DOI: 10.1007/s11938-020-00317-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/23/2020] [Indexed: 12/24/2022]
Abstract
Purpose of review Colorectal cancer (CRC) is the second most common cause of cancer death worldwide, killing approximately 900,000 people each year. An individual’s risk of developing CRC is multi-factorial with known risk factors including increasing age, male sex, family history of CRC and raised body mass index. Population-based screening programmes for CRC exist in many countries, and in the United Kingdom (UK), screening is performed through the NHS Bowel Cancer Screening Programme (BCSP). Screening programmes offer a population-based approach for those at “average risk”, and do not typically offer enhanced screening for groups at increased risk. In the UK, such patients are managed via non-screening symptomatic services but in a non-systematic way. Recent findings There is growing evidence that conditions such as cystic fibrosis and a history of childhood cancer are associated with higher risk of CRC, and surveillance of these groups is advocated by some organizations; however, national recommendations do not exist in most countries. Summary We review the evidence for screening “high risk” groups not covered within most guidelines and discuss health economic issues requiring consideration acknowledging that the demand on colonoscopy services is already overwhelming.
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Pan D, Xu W, Gao X, Yiyang F, Wei S, Zhu G. Survival outcomes in esophageal cancer patients with a prior cancer. Medicine (Baltimore) 2021; 100:e24798. [PMID: 33607840 PMCID: PMC7899859 DOI: 10.1097/md.0000000000024798] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 01/28/2021] [Indexed: 01/05/2023] Open
Abstract
To achieve a deeper understanding of patients who developed esophageal cancer (EC) as a second primary malignancy, which may help guide in clinical practice for these patients in the future.In the primary cohort, EC patients with a prior malignancy were identified from the surveillance, epidemiology, and end result 18 database. The 5 most common types of prior cancers were picked out based on the frequency of occurrence. In addition, Kaplan-Meier and log-rank tests were performed to investigate the survival impacts of prior cancers on EC patients. Besides, a competing-risk model was constructed to explore the relationship between EC-treatment and EC-specific mortality. In the secondary cohort, patients with stage I-III (N0M0) EC from 2004 to 2014 were enrolled. After propensity score matching, univariate and multivariate Cox analyses were developed to determine the prognostic factors for EC patients.A total of 1199 EC patients with a prior cancer were identified in the primary cohort. The 5 most common sites of prior cancers were prostate, female breast, bladder, lung and bronchus, and larynx. Kaplan-Meier analyses revealed that EC patients with prior prostate cancer and bladder cancer had the best overall survival (OS), while those with prior cancers of larynx and lung and bronchus had the worst OS. Fine and Gray competing risks analysis indicated that the administration of surgery was closely associated with better EC-specific survival (P < .001). In the secondary cohort, multivariate Cox analyses found that age at diagnosis, race, tumor grade, tumor extent, nodal status and metastasis stage, histology, and the administration of surgery were prognostic factors for OS and cancer-specific survival in EC patients. Besides, the existence of a prior cancer was an independent prognostic factor for cancer-specific survival.EC remains to be the most important cause of death in EC patients with a prior cancer. EC related treatment should be actively adopted in patients with a prior cancer, as they were more likely to die from EC than the prior cancer. EC patients with a prior cancer had comparable OS than those without.
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Zang Y, Qi F, Cheng Y, Xia T, Xiao R, Li X, Yang N. Survival outcomes in prostate cancer patients with a prior cancer. Transl Androl Urol 2021; 10:741-753. [PMID: 33718076 PMCID: PMC7947467 DOI: 10.21037/tau-20-897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background To shed light on the survival outcomes of prostate cancer (PCa) patients diagnosed after a prior cancer and identify prognostic factors for overall survival (OS) and cancer-specific survival (CSS) in PCa patients. Methods In the primary group, a total of 1,778 PCa patients with a prior cancer were identified in the Surveillance, Epidemiology, and End Results (SEER) database from 2005 to 2015, retrospectively. Baseline characteristics and causes of death (COD) of these patients were collected and compared. In the second group, a total of 10,296 PCa patients [5,148 patients with PCa as the only malignancy and 5,148 patients with PCa as their second primary malignancy (SPM)] diagnosed between 2010 and 2011 were extracted to investigate the impact of prior cancers on survival outcomes. Results In PCa patients with a prior cancer, the most common type of prior cancer was from gastrointestinal system (29.92%), followed by urinary system (21.37%). Patients were more likely to die of the prior caner, and those with prior cancer from respiratory system had the worst survival outcomes. Moreover, the overall ratios in patients with stage (PCa) I–II and III–IV diseases were 0.21 and 1.65, indicating that patients with higher stage diseases were more likely to die of PCa. In the second group, patients with PCa as the SPM had worse OS than those with PCa as the first primary cancer. Lastly, prognostic factors for OS and CSS in PCa patients were explored. Conclusions PCa remains to be an important COD for patients with a prior malignancy, especially for those with high-stage diseases. PCa patients with a prior cancer had worse survival outcomes than those without.
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Affiliation(s)
- Yan Zang
- Department of Bariatric and Metabolic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Feng Qi
- Department of Urologic Surgery, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Yifei Cheng
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Tian Xia
- Department of Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Rongrong Xiao
- Department of Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Xiao Li
- Department of Urologic Surgery, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Ningli Yang
- Department of Bariatric and Metabolic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Newme K, Hajong R, Bhuyan RK. A clinical study on surgical causes of Hematuria. J Family Med Prim Care 2021; 10:265-271. [PMID: 34017738 PMCID: PMC8132832 DOI: 10.4103/jfmpc.jfmpc_1750_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/27/2020] [Accepted: 12/05/2020] [Indexed: 11/30/2022] Open
Abstract
Introduction: Hematuria is a clinical sign and symptom that every individual would have a worst nightmare and invokes a physician to carefully evaluate possible causes of hematuria. It may be medical or surgical causes. A thorough examination is required to exact the primary pathology. As such, a study on hematuria in North east India is not sufficiently researched or published. Material & methods: Here we present an observational study in our institution on that very topic. A study was done purely on surgical causes of hematuria on symptomatic patients. It was done on the inpatient and outpatient basis in Assam Medical College, Dibrugarh during the period of 2016–2019. Total 43 patients were evaluated, who came with symptomatic hematuria. Results: Out of 43 cases of symptomatic hematuria, 34 were male and 9 were females patients. Carcinoma urinary bladder was the commonest cause of hematuria, followed by BPH, urolithiasis, carcinoma prostrate, carcinoma upper urinary tract, etc. Conclusion: Benign prostatic hyperplasia was found to be the most common benign cause and carcinoma bladder was the commonest malignant cause of hematuria.
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Affiliation(s)
| | - Ranendra Hajong
- Associate Professor, Department of General Surgery, NEIGRIHMS, Shillong, Meghalaya, India
| | - Ratna Kanta Bhuyan
- Professor, Department of General Surgery, Assam Medical College, Dibrugarh, Assam, India
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Guan X, Wei R, Yang R, Lu Z, Liu E, Zhao Z, Chen H, Yang M, Liu Z, Jiang Z, Wang X. Risk and Prognosis of Secondary Bladder Cancer After Radiation Therapy for Rectal Cancer: A Large Population-Based Cohort Study. Front Oncol 2021; 10:586401. [PMID: 33569344 PMCID: PMC7868538 DOI: 10.3389/fonc.2020.586401] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 12/07/2020] [Indexed: 11/13/2022] Open
Abstract
Background Although radiation therapy (RT) improves local control for rectal cancer (RC), the long-term risks from RT, including development of a secondary malignancy, are controversial. The risk and prognosis of secondary bladder cancer (SBC) in RC patients undergoing RT have not been adequately studied. Our goal is to investigate the impact of RT on the risk of developing SBC and assess their survival outcomes. Methods This large population-based study included RC patients as their initial primary cancer from nine registries of the Surveillance, Epidemiology and End Results (SEER) database between 1973 and 2015. The cumulative incidence of SBC was assessed by using Fine and Gray's competing risk regression. The standardized incidence ratio (SIR) was used to compare the incidence of SBC in RC survivors to the US general population. The Kaplan-Meier method was used to evaluate the 10-year overall survival (OS) and 10-year cancer specific survival (CSS) for patients with SBC. Results Of 74,646 RC patients, 24,522 patients were treated with surgery and RT and 50,124 patients were treated with surgery alone. The incidence of SBC was 1.85% among patients who received RT and 1.24% among patients who did not. The incidence of SBC in RC patients who received RT was higher than the US general population (SIR, 1.35; 95% CI, 1.19-1.53, P<0.05), and decreased with increasing age at diagnosis, and increased with time since diagnosis. In competing risk regression analysis, undergoing RT was associated with a higher risk of SBC (hazard ratio [HR], 1.443, 95% confidence interval [CI], 1.209-1.720; P<0.001). The results of the dynamic SIR for SBC revealed that a slightly increased risk of SBC was observed after RT in the early latency, and was significantly related to the variations of age at RC diagnosis and decreased with time progress. The 10-year OS and CSS among SBC patients after RT were comparable to SBC patients after NRT. Conclusion Radiation was associated with an increased risk of developing SBC in RC patients, and special attention should be paid to the surveillance of these patients.
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Affiliation(s)
- Xu Guan
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ran Wei
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Runkun Yang
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Zhao Lu
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Enrui Liu
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhixun Zhao
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Haipeng Chen
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ming Yang
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zheng Liu
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zheng Jiang
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xishan Wang
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,The Second Affiliated Hospital of Harbin Medical University, Harbin, China
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Guo B, Liu M. Rural-urban variation in characteristics among prostate cancer patients. World J Urol 2021; 40:611. [PMID: 33388919 DOI: 10.1007/s00345-020-03542-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 11/23/2020] [Indexed: 11/28/2022] Open
Affiliation(s)
- Boda Guo
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, China.,Graduate School of Peking, Union Medical College, Beijing, 100730, People's Republic of China
| | - Ming Liu
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, China. .,Graduate School of Peking, Union Medical College, Beijing, 100730, People's Republic of China.
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Jahreiß MC, Aben KKH, Hoogeman MS, Dirkx MLP, de Vries KC, Incrocci L, Heemsbergen WD. The Risk of Second Primary Cancers in Prostate Cancer Survivors Treated in the Modern Radiotherapy Era. Front Oncol 2020; 10:605119. [PMID: 33282746 PMCID: PMC7691574 DOI: 10.3389/fonc.2020.605119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 10/20/2020] [Indexed: 12/26/2022] Open
Abstract
Purpose Concerns have been raised that modern intensity modulated radiotherapy (IMRT) may be associated with increased second primary cancer risks (SPC) compared to previous three-dimensional conformal radiation techniques (3DCRT), due to increased low dose volumes and more out-of-field ionizing dose to peripheral tissue further away from the target. We assessed the impact of treatment technique on SPC risks in a cohort of prostate cancer (PCa) survivors. Material and Methods The study cohort comprised 1,561 PCa survivors aged 50–79 years at time of radiotherapy, treated between 2006–2013 (N=707 IMRT, N=854 3DCRT). Treatment details were extracted from radiotherapy systems and merged with longitudinal data of the Netherlands Cancer Registry to identify SPCs. Primary endpoint was the development of a solid SPC (excluding skin cancer) in peripheral anatomical regions, i.e. non-pelvic. Applied latency period was 12 months. SPC rates in the IMRT cohort (total cohort and age subgroups) were compared to 1) the 3DCRT cohort by calculating Sub-Hazard Ratios (sHR) using a competing risk model, and 2) to the general male population by calculating Standardized Incidence Ratios (SIR). Models were adjusted for calendar period and age. Results Median follow-up was 8.0 years (accumulated 11,664 person-years at-risk) with 159 cases developing ≥1 non-pelvic SPC. For IMRT vs 3DCRT we observed a significantly (p=0.03) increased risk (sHR=1.56, 95% Confidence Interval (CI) 1.03–2.36, corresponding estimated excess absolute risk (EAR) of +7 cases per 10,000 person-years). At explorative analysis, IMRT was in particular associated with increased risks within the subgroup of active smokers (sHR 2.94, p=0.01). Within the age subgroups 50–69 and 70–79 years, the sHR for non-pelvic SPC was 3.27 (p=0.001) and 0.96 (p=0.9), respectively. For pelvic SPC no increase was observed (sHR=0.8, p=0.4). Compared to the general population, IMRT was associated with significantly increased risks for non-pelvic SPC in the 50–69 year age group (SIR=1.90, p<0.05) but not in the 70–79 years group (SIR=1.08). Conclusion IMRT is associated with increased SPC risks for subjects who are relatively young at time of treatment. Additional research on aspects of IMRT that may cause this effect is essential to minimize risks for future patients receiving modern radiotherapy.
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Affiliation(s)
| | - Katja K H Aben
- Department of Research & Development, Netherlands Comprehensive Cancer Organization, Utrecht, Netherlands.,Research Institute for Health Sciences, Radboudumc, Nijmegen, Netherlands
| | - Mischa S Hoogeman
- Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Maarten L P Dirkx
- Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Kim C de Vries
- Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Luca Incrocci
- Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Wilma D Heemsbergen
- Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, Netherlands
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Radiation versus surgery in patients with clinically localized Gleason 9-10 prostate cancer. World J Urol 2020; 40:303-304. [PMID: 33201357 DOI: 10.1007/s00345-020-03521-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 10/30/2020] [Indexed: 10/23/2022] Open
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Park J, Han K, Shin DW, Park SH, Shin HB. Conditional Relative Survival and Competing Mortality of Patients with Prostate Cancer in Korea: A Nationwide Cohort Study. Cancer Epidemiol Biomarkers Prev 2020; 30:326-334. [PMID: 33187966 DOI: 10.1158/1055-9965.epi-20-1084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/16/2020] [Accepted: 11/09/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Conditional relative survival (CRS) and competing mortality are important survivorship issues after cancer treatment. We aimed to investigate them among patients with prostate cancer treated by various modalities. METHODS Using a nationwide population-based database, we calculated 5-year CRS conditioned on 1 through 5 years survival after diagnosis. These rates were stratified by age, sex, socioeconomic status, comorbidities, and treatment received. Cause of death and estimated cause-specific mortality were also described and considered with competing risks. RESULTS A total of 81,773 patients newly diagnosed with primary prostate cancer from 2007 to 2013 were identified. The 5-year CRS was 81.1% at baseline, but increased gradually up to 95.4% at 4 years and exceeded 100% at 5 years after diagnosis, suggesting no excess mortality compared with the general population. However, this pattern differed by treatment received. Patients who underwent androgen deprivation therapy showed 5-year CRS of only 88.4% at 5 years after diagnosis, implying persistent excess mortality. Prostate cancer constituted around one-third of deaths, while other cancers were the main cause of death within <2 years after diagnosis. Noncancer-related deaths, including cardiovascular disease and respiratory disease, increased with time since diagnosis. CONCLUSIONS CRS rates for patients with prostate cancer improved over time and exceeded that of the general population at 5 years. Other cancers were the main cause of death in the earlier survivorship phase, and deaths from noncancer causes gradually increased over time. IMPACT Our findings will help patients and clinicians make evidence-based decisions on the basis of a patient's dynamic risk profile.
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Affiliation(s)
- Jinsung Park
- Department of Urology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (South)
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea (South)
| | - Dong Wook Shin
- Department of Family Medicine/Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (South). .,Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea (South).,Department of Digital Health, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea (South)
| | - Sang Hyun Park
- Department of Medical Statistics, The Catholic University of Korea, Seoul, Republic of Korea (South)
| | - Hyun Bin Shin
- Department of Urology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (South)
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Treutwein M, Loeschel R, Hipp M, Koelbl O, Dobler B. Secondary malignancy risk for patients with localized prostate cancer after intensity-modulated radiotherapy with and without flattening filter. J Appl Clin Med Phys 2020; 21:197-205. [PMID: 33147377 PMCID: PMC7769399 DOI: 10.1002/acm2.13088] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 09/16/2020] [Accepted: 07/24/2020] [Indexed: 12/20/2022] Open
Abstract
Men treated for localized prostate cancer by radiotherapy have often a remaining life span of 10 yr or more. Therefore, the risk for secondary malignancies should be taken into account. Plans for ten patients were evaluated which had been performed on an Oncentra® treatment planning system for a treatment with an Elekta Synergy™ linac with Agility™ head. The investigated techniques involved IMRT and VMTA with and without flattening filter. Different dose response models were applied for secondary carcinoma and sarcoma risk in the treated region and also in the periphery. As organs at risk we regarded for carcinoma risk urinary bladder, rectum, colon, esophagus, thyroid, and for sarcoma risk bone and soft tissue. The excess absolute risk (EAR) was found very similar in the treated region for both techniques (IMRT and VMAT) and also for both with and without flattening filter. The secondary sarcoma risk resulted about one magnitude smaller than the secondary carcinoma risk. The EAR to the peripheral organs was statistically significant reduced by application of the flattening filter free mode concerning the flattening filter as main source of scattered dose. Application of flattening filter free mode can thus support to reduce second malignancy risk for patients with localized prostate cancer.
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Affiliation(s)
- Marius Treutwein
- Department for radiotherapy, Regensburg University Medical Center, Regensburg, Germany
| | - Rainer Loeschel
- Faculty of computer science and mathematics, Ostbayerische Technische Hochschule, Regensburg, Germany
| | - Matthias Hipp
- Department for radiotherapy, Regensburg University Medical Center, Regensburg, Germany.,Strahlentherapie, Klinikum St. Marien, Amberg, Germany
| | - Oliver Koelbl
- Department for radiotherapy, Regensburg University Medical Center, Regensburg, Germany
| | - Barbara Dobler
- Department for radiotherapy, Regensburg University Medical Center, Regensburg, Germany
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Racial and ethnic differences in risk of second primary cancers among prostate cancer survivors. Cancer Causes Control 2020; 31:1011-1019. [PMID: 32839916 DOI: 10.1007/s10552-020-01336-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 08/06/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Previous studies have shown an overall decreased risk of second cancers among prostate cancer survivors, but this has not been comprehensively examined by race/ethnicity. We conducted a retrospective cohort study of 716,319 one-year survivors of prostate cancer diagnosed at ages 35-84 during 2000-2015 as reported to 17 US Surveillance, Epidemiology and End Results (SEER) registries. METHODS We estimated standardized incidence ratios (SIRs) for second primary non-prostate malignancies by race/ethnicity (non-Latino white, Black, Asian/Pacific Islander [API] and Latino), by Gleason, and by time since prostate cancer diagnosis. Poisson regression models were used to test heterogeneity between groups with the expected number as the offset. RESULTS 60,707 second primary malignancies were observed. SIRs for all second cancers combined varied significantly by race/ethnicity: SIRwhite: 0.88 (95% confidence interval: 0.87-0.89), SIRLatino: 0.92 (0.89-0.95), SIRBlack: 0.97 (0.95-0.99), and SIRAPI: 1.05 (1.01-1.09) (p-heterogeneity < 0.001). SIRs for all cancers combined were higher among survivors of higher vs. lower Gleason prostate cancers irrespective of race/ethnicity. We observed significant heterogeneity by race/ethnicity in SIRs for 9 of 14 second cancer types investigated including lung, bladder, kidney, and liver. CONCLUSIONS Our results confirm that most prostate cancer survivors have lower risks of second cancers than expected, but the magnitude varied by race/ethnicity. Exceptionally, API men had small but significantly increased risk. Further research to understand drivers of the observed race/ethnicity heterogeneity is warranted.
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Bhattacharjee A, Roy G, Budukh A, Dikshit R, Patil VM, Joshi A, Noronha V, Prabash K, Roy P. A competing risk analysis of death patterns in male genitourinary cancer. Cancer Rep (Hoboken) 2020; 3:e1174. [DOI: 10.1002/cnr2.1174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 12/26/2018] [Accepted: 12/26/2018] [Indexed: 11/11/2022] Open
Affiliation(s)
- Atanu Bhattacharjee
- Section of Biostatistics, Centre for Cancer EpidemiologyTata Memorial Centre Navi Mumbai India
| | - Gaurav Roy
- Molecular Genetics Laboratory, Institute of Medical Genetics and GenomicsSir Ganga Ram Hospital New Delhi India
| | - Atul Budukh
- Centre for Cancer EpidemiologyTata Memorial Centre Navi Mumbai India
| | - Rajesh Dikshit
- Centre for Cancer EpidemiologyTata Memorial Centre Navi Mumbai India
| | - Vijay M. Patil
- Department of Medical Oncology, Tata Memorial HospitalTata Memorial Centre Mumbai India
| | - Amit Joshi
- Department of Medical Oncology, Tata Memorial HospitalTata Memorial Centre Mumbai India
| | - Vanita Noronha
- Department of Medical Oncology, Tata Memorial HospitalTata Memorial Centre Mumbai India
| | - Kumar Prabash
- Department of Medical Oncology, Tata Memorial HospitalTata Memorial Centre Mumbai India
| | - Papai Roy
- Biochemical Genetics LaboratoryInstitute of Medical Genetics and Genomics, Sir Ganga Ram Hospital New Delhi India
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