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Celentano G, Creta M, Napolitano L, Abate M, La Rocca R, Capece M, Mirone C, Morra S, Di Bello F, Cirillo L, Mangiapia F, Califano G, Collà Ruvolo C, Sagnelli C, Sica A, Calogero A, Iacono F, Fusco F, Mirone V, Longo N. Prostate Cancer Diagnosis, Treatment and Outcomes in Patients with Previous or Synchronous Colorectal Cancer: A Systematic Review of Published Evidence. Diagnostics (Basel) 2022; 12:diagnostics12061475. [PMID: 35741285 PMCID: PMC9221875 DOI: 10.3390/diagnostics12061475] [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: 05/30/2022] [Revised: 06/11/2022] [Accepted: 06/13/2022] [Indexed: 11/18/2022] Open
Abstract
The management of patients with prostate cancer (PCa) and previous or synchronous colorectal cancer (CRC) represents a challenging issue. A systematic review was performed in May 2022 to summarize available evidence about the diagnosis, management, and outcomes of these patients. Twenty-seven studies involving 252 patients were identified. Overall, 163 (64.7%) and 89 (35.3%) patients had synchronous and metachronous PCa and CRC, respectively. In patients with synchronous diseases, PCa treatment involved active surveillance in 1 patient, radical prostatectomy (RP) in 36 patients, radiotherapy (RT) in 60 patients, RP plus RT in 1 patient, proton beam therapy in 1 patient, and cryoablation in 1 patient. In patients with previous CRC treatment, prostate biopsy was mostly performed by transrectal approach (n = 24). The trans-perineal and suprapubic approaches were adopted in 12 and 6 cases, respectively. Surgical PCa treatment in these cases involved endoscopic extraperitoneal RP, robot-assisted RP, and not otherwise specified RP in 30, 15, and 2 cases, respectively. Biochemical recurrence rates ranged from 20% to 28%. Non-surgical PCa treatment options included brachytherapy, RT plus androgen deprivation therapy, and RT alone in 23, 2 and 4 patients, respectively. PCa specific survival was reported by one study and was 100%.
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Affiliation(s)
- Giuseppe Celentano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
- Correspondence: ; Tel./Fax: +39-081-7462-611
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Marco Abate
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Roberto La Rocca
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Marco Capece
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Claudia Mirone
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania “Luigi Vanvitelli”, 80123 Naples, Italy;
| | - Simone Morra
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Francesco Di Bello
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Luigi Cirillo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Francesco Mangiapia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Gianluigi Califano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Claudia Collà Ruvolo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy;
| | - Antonello Sica
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80123 Naples, Italy;
| | - Armando Calogero
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80130 Naples, Italy;
| | - Fabrizio Iacono
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Ferdinando Fusco
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy;
| | - Vincenzo Mirone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
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Dema S, Bota A, Tăban SM, Gheju A, Dema ALC, Croitor A, Barna RA, Popa O, Bardan R, Cumpănaș AA. Multiple Primary Tumors Originating From the Prostate and Colorectum A Clinical-Pathological and Therapeutic Challenge. Am J Mens Health 2021; 15:15579883211044881. [PMID: 34493123 PMCID: PMC8436322 DOI: 10.1177/15579883211044881] [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] [Indexed: 01/22/2023] Open
Abstract
Considering that the incidence of colorectal (CRC) and prostatic cancer (PC) increases with age, metachronous and synchronous tumors can often affect the same patient. Despite the importance of this subject for the diagnosis and management of oncologic patients, in medical literature the data are scarce. The aim of the study was to evaluate the incidence and the characteristics of double/multiple primary malignant tumors (D/MPMTs) with colorectal and prostatic origin, in patients admitted to a reference hospital in West Romania. A 4-year retrospective observational study (2016–2019) was conducted by analyzing the medical records of all patients admitted in the hospital. Demographic and clinical data, as well as tumor-related parameters, were extracted. We identified 413 consecutive hospitalized patients with PC, and 21 (5%) of them also had a primary CRC. At the time of diagnosis, the mean age of the patients with PC was 71.2 ± 6 years, and 71.8 ± 10 years for patients with CRC. Synchronous PC and CRC tumors were identified in 3/21 cases and metachronous tumors in 18/21 cases. Prostate cancer was the first tumor to be diagnosed in 13/18 cases and CRC in 5/18 cases. The most frequent subtype of PC was acinar adenocarcinoma (90%) and for CRC cases, conventional adenocarcinoma (90%). Prostate and colorectal cancers tend to co-occur in a single patient. The diagnosis of one of these two types of tumors should imply the screening for the other one, because these patients require a multidisciplinary and personalized approach.
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Affiliation(s)
- Sorin Dema
- Radiotherapy Service, Emergency City Hospital Timisoara, Timisoara, Romania
| | - Andreea Bota
- Department II Microscopic Morphology-Discipline of Morphopathology, "Anapatmol" Research Center, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Sorina Maria Tăban
- Department II Microscopic Morphology-Discipline of Morphopathology, "Anapatmol" Research Center, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Adelina Gheju
- Department II Microscopic Morphology-Discipline of Morphopathology, "Anapatmol" Research Center, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Alis Liliana Carmen Dema
- Department II Microscopic Morphology-Discipline of Morphopathology, "Anapatmol" Research Center, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Alexei Croitor
- Urology Department, Emergency County Hospital Timisoara, Timisoara, Romania
| | - Robert Alexandru Barna
- Department II Microscopic Morphology-Discipline of Morphopathology, "Anapatmol" Research Center, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.,Department of Internal Medicine II-Discipline of Gastroenterology and Hepatology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Oana Popa
- Department II Microscopic Morphology-Discipline of Morphopathology, "Anapatmol" Research Center, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Răzvan Bardan
- Department of Orthopedic Surgery-Traumatology-Urology-Medical Imaging-Urology Department, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Alin-Adrian Cumpănaș
- Department of Orthopedic Surgery-Traumatology-Urology-Medical Imaging-Urology Department, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
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Jacobs CD, Trotter J, Palta M, Moravan MJ, Wu Y, Willett CG, Lee WR, Czito BG. Multi-Institutional Analysis of Synchronous Prostate and Rectosigmoid Cancers. Front Oncol 2020; 10:345. [PMID: 32266135 PMCID: PMC7105852 DOI: 10.3389/fonc.2020.00345] [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: 07/17/2019] [Accepted: 02/27/2020] [Indexed: 12/24/2022] Open
Abstract
Purpose: To perform a multi-institutional analysis of patients with synchronous prostate and rectosigmoid cancers. Materials and Methods: A retrospective review of Duke University and Durham Veterans Affairs Medical Center records was performed for men with both prostate and rectosigmoid adenocarcinomas from 1988 to 2017. Synchronous presentation was defined as symptoms, diagnosis, or treatment of both cancers within 12 months of each other. The primary study endpoint was overall survival. Univariate and multivariable Cox regression was performed. Results: Among 31,883 men with prostate cancer, 330 (1%) also had rectosigmoid cancer and 54 (16%) of these were synchronous. Prostate cancer was more commonly the initial diagnosis (59%). Fifteen (28%) underwent prostatectomy or radiotherapy before an established diagnosis of rectosigmoid cancer. Stage I, II–III, or IV rectosigmoid cancer was present in 26, 57, and 17% of men, respectively. At a median follow-up of 43 months, there were 18 deaths due rectosigmoid cancer and two deaths due to prostate cancer. Crude late grade ≥3 toxicities include nine (17%) gastrointestinal and six (11%) genitourinary. Two anastomotic leaks following low anterior resection occurred in men who received a neoadjuvant radiotherapy prostate dose of 70.6–76.4 Gy. Rectosigmoid cancer stages II–III (HR 4.3, p = 0.02) and IV (HR 16, p < 0.01) as well as stage IV prostate cancer (HR 31, p < 0.01) were associated with overall survival on multivariable analysis. Conclusions: Synchronous rectosigmoid cancer is a greater contributor to mortality than prostate cancer. Men aged ≥45 with localized prostate cancer should undergo colorectal cancer screening prior to treatment to evaluate for synchronous rectosigmoid cancer.
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Affiliation(s)
- Corbin D Jacobs
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, United States
| | - Jacob Trotter
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, United States
| | - Manisha Palta
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, United States.,Department of Radiation Oncology, Durham Veteran Affairs Medical Center, Durham, NC, United States
| | - Michael J Moravan
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, United States.,Department of Radiation Oncology, Durham Veteran Affairs Medical Center, Durham, NC, United States
| | - Yuan Wu
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, United States
| | - Christopher G Willett
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, United States
| | - W Robert Lee
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, United States.,Department of Radiation Oncology, Durham Veteran Affairs Medical Center, Durham, NC, United States
| | - Brian G Czito
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, United States.,Department of Radiation Oncology, Durham Veteran Affairs Medical Center, Durham, NC, United States
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Nakano M, Araki H, Ohtakara K, Tanaka H, Iinuma K, Deguchi T. Significance of total colonoscopy screening before definitive radiotherapy for prostate cancer on the detection of anorectocolonic disease requiring intervention in advance. Int J Urol 2017; 25:166-168. [DOI: 10.1111/iju.13494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Masahiro Nakano
- Department of Urology; Gifu University Graduate School of Medicine; Gifu Japan
| | - Hiroshi Araki
- Department of Gastroenterology/Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Kazuhiro Ohtakara
- Department of Radiology; Nagoya University Graduate School of Medicine; Nagoya Aichi Japan
| | - Hidekazu Tanaka
- Department of Radiology; Gifu University Graduate School of Medicine; Gifu Japan
| | - Koji Iinuma
- Department of Urology; Gifu University Graduate School of Medicine; Gifu Japan
| | - Takashi Deguchi
- Department of Urology; Gifu University Graduate School of Medicine; Gifu Japan
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Ko SH, Baeg MK, Bae WJ, Kim P, Choi MG. Prostate cancer patients may have an increased risk of coexisting advanced colorectal neoplasms. Onco Targets Ther 2016; 9:5611-7. [PMID: 27672332 PMCID: PMC5024772 DOI: 10.2147/ott.s110595] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background/aims Patients being treated for prostate cancer (PCa) have an increased risk of developing colorectal cancer. However, whether PCa patients are inherently at a higher risk of colorectal neoplasms (CRNs) is unknown. We aimed to investigate the risk of CRNs in PCa patients. Materials and methods Patients who had been diagnosed with PCa at a tertiary medical center and had colonoscopy within 1 year of the PCa diagnosis were investigated. Patients were propensity-matched 1:2 by age and body mass index to asymptomatic control subjects who had undergone colonoscopy for routine health screening. CRN was defined as histological confirmation of an adenoma or adenocarcinoma component. Advanced CRN was defined as any of the following: 1) histological findings of high-grade dysplasia, 2) inclusion of villous features, 3) tumor ≥1 cm in size, or 4) presence of an adenocarcinoma. Risk factors for CRN and advanced CRN were evaluated by univariate and multivariate analysis. Results A total of 191 patients diagnosed with PCa had colonoscopies within 1 year of PCa diagnosis. Of these, 23 patients with a history of previous malignancy and seven with incomplete colonoscopies were excluded, leaving 161 patients in the PCa group. Although presence of PCa was not a significant risk factor for CRN by multivariate analysis, PCa was a significant risk factor for advanced CRN (odds ratio [OR] 3.300; 95% confidence interval [CI] 1.766–6.167; P<0.001). Other significant risk factors for advanced CRN were age (OR 1.050; 95% CI 1.003–1.009; P=0.036) and body mass index (OR 1.205; 95% CI 1.067–1.361; P=0.003), whereas aspirin use (OR 0.414; 95% CI 0.173–0.990; P=0.047) was a preventive factor. Conclusion The risk of advanced CRN may be significantly increased in patients with PCa. Patients with PCa should have a colonoscopy at the time of PCa diagnosis.
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Affiliation(s)
- Sun-Hye Ko
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Myong Ki Baeg
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Department of Internal Medicine, International St Mary's Hospital, Catholic Kwandong University, Incheon, South Korea
| | - Woong Jin Bae
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Pumsoo Kim
- Department of Internal Medicine, International St Mary's Hospital, Catholic Kwandong University, Incheon, South Korea
| | - Myung-Gyu Choi
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Ng SP, Tran T, Moloney P, Sale C, Mathlum M, Ong G, Lynch R. Synchronous prostate and rectal adenocarcinomas irradiation utilising volumetric modulated arc therapy. J Med Radiat Sci 2016; 62:286-91. [PMID: 27512575 PMCID: PMC4968563 DOI: 10.1002/jmrs.143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 08/24/2015] [Accepted: 08/25/2015] [Indexed: 11/24/2022] Open
Abstract
Cases of synchronous prostate and colorectal adenocarcinomas have been sporadically reported. There are case reports on patients with synchronous prostate and rectal cancers treated with external beam radiotherapy alone or combined with high‐dose rate brachytherapy boost to the prostate. Here, we illustrate a patient with synchronous prostate and rectal cancers treated using the volumetric arc therapy (VMAT) technique. The patient was treated with radical radiotherapy to 50.4 Gy in 28 fractions to the pelvis, incorporating the involved internal iliac node and the prostate. A boost of 24 Gy in 12 fractions was delivered to the prostate only, using VMAT. Treatment‐related toxicities and follow‐up prostate‐specific antigen and carcinoembryonic antigen were collected for data analysis. At 12 months, the patient achieved complete response for both rectal and prostate cancers without significant treatment‐related toxicities.
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Affiliation(s)
- Sweet Ping Ng
- Department of Radiation Oncology Andrew Love Cancer Centre Barwon Health Geelong Australia; Peter MacCallum Cancer Centre Melbourne Australia
| | - Thu Tran
- Department of Radiation Oncology Andrew Love Cancer Centre Barwon Health Geelong Australia
| | - Philip Moloney
- Department of Radiation Oncology Andrew Love Cancer Centre Barwon Health Geelong Australia
| | - Charlotte Sale
- Department of Radiation Oncology Andrew Love Cancer Centre Barwon Health Geelong Australia
| | - Maitham Mathlum
- Department of Radiation Oncology Andrew Love Cancer Centre Barwon Health Geelong Australia
| | - Grace Ong
- Department of Radiation Oncology Andrew Love Cancer Centre Barwon Health Geelong Australia; Peter MacCallum Cancer Centre Melbourne Australia
| | - Rod Lynch
- Department of Radiation Oncology Andrew Love Cancer Centre Barwon Health Geelong Australia
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