Prognosis of Prostate Cancer With Other Primary Malignancies

Abstract

PurposeThe objective was to investigate the clinicopathological characteristics and the prognosis of prostate cancer patients affected by other primary malignancies.Materials and MethodsFrom 1990 to 2008, we retrospectively reviewed the medical records of 1,317 patients who underwent radical prostatectomy (RP) for prostate cancer. We assessed the effect of other primary malignancies on clinicopathological features, biochemical recurrence (BCR)-free survival, cancer-specific survival (CSS), and overall survival (OS).ResultsOf 1,317 patients, at least one additional other primary malignancy was detected in 187 patients (14.2%). A comparison of patient groups according to the presence or absence of other primary malignancies showed no significant differences in preoperative serum prostate-specific antigen concentrations, pathological Gleason scores, or pathological staging. Prostate cancer patients with other primary malignancies were older than patients without other primary malignancies (p<0.001). No significant differences in 5-year BCR-free survival (80.2% compared with 77.7%; p=0.656) or CSS (98.9% compared with 98.5%; p=0.733) were found between these groups, respectively. Five-year OS was significantly lower in prostate cancer patients with than in those without other primary malignancies (89.3% compared with 95.4%; p<0.001). Multivariate analysis showed that other primary malignancies diagnosed after RP for prostate cancer were independent predictors of OS (hazard ratio, 4.10; p<0.001) but not of BCR-free survival or CSS. Conversely, other primary malignancies diagnosed before RP for prostate cancer did not independently predict BCR-free survival, OS, or CSS.ConclusionsProstate cancer prognosis after RP is not dependent on the presence or absence of other primary malignancies. However, other primary malignancies diagnosed after RP for prostate cancer negatively affect OS.

Impact of latency time on survival for adolescents and young adults with a second primary malignancy

“…A few studies of older adult populations of either prostate or renal cell carcinoma survivors compared survival for patients who did and did not develop an SPM. [35][36][37][38] None demonstrated a difference in CSS in this older cohort, but they did show a detrimental impact on overall survival. Again, neither latency nor adjustments for age, race/ethnicity, or the stages of both cancers were detailed.…”

“…All showed an increased risk of death if a tumor occurred as an SPM versus a primary cancer, although few evaluated whether death was due to the PM or SPM. A few studies of older adult populations of either prostate or renal cell carcinoma survivors compared survival for patients who did and did not develop an SPM . None demonstrated a difference in CSS in this older cohort, but they did show a detrimental impact on overall survival.…”

Prevalence and clinical significance of incidental18F-fluoro-2-deoxyglucose uptake in prostate

“…Incidental FDG uptake in the prostate is often experienced in clinical practice, but SUV alone cannot determine whether increased uptake indicates a malignancy or a benign state. Detection of second primary cancers, particularly early cancers that require radical treatment, is important because these cancers can significantly influence patient management [ 10 , 11 ]. We therefore investigated the prevalence and clinical significance of incidental prostate FDG uptake and evaluated its impact on patient management.…”