The Rate of Secondary Malignancies After Radical Prostatectomy Versus External Beam Radiation Therapy for Localized Prostate Cancer: A Population-Based Study on 17,845 Patients

Bhojani, Naeem; Capitanio, Umberto; Suardi, Nazareno; Jeldres, Claudio; Isbarn, Hendrik; Shariat, Shahrokh F.; Graefen, Markus; Arjane, Philippe; Duclos, Alain; Lattouf, Jean Baptiste; Saad, Fred; Valiquette, Luc; Montorsi, Francesco; Perrotte, Paul; Karakiewicz, Pierre I.

doi:10.1016/j.ijrobp.2009.02.011

Cited by 86 publications

(53 citation statements)

References 34 publications

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“…Hand-searching the references of relevant articles and actual treatment guidelines did not reveal any additional relevant studies. Six references seemed to meet the eligibility criteria and were obtained as full-text papers [13,14,15,16,17,18]. Two studies analyzed the hazards ratio (HR) of patients receiving RT over radical prostatectomy, one only reported HR without 95% CIs, and another included cancers occurring within the first 6 months after the start of the treatment, which were excluded [15,16].…”

Section: Resultsmentioning

confidence: 99%

“…Six references seemed to meet the eligibility criteria and were obtained as full-text papers [13,14,15,16,17,18]. Two studies analyzed the hazards ratio (HR) of patients receiving RT over radical prostatectomy, one only reported HR without 95% CIs, and another included cancers occurring within the first 6 months after the start of the treatment, which were excluded [15,16]. Other four studies investigating the standardized incidence ratio (SIR), which was deﬁned as the ratio between the observed and expected number of cases with the general population as the reference, were included for qualitative synthesis (table 1) [17,18,19,20].…”

Section: Resultsmentioning

confidence: 99%

“…Most single-institution studies were unable to detect any increased bladder cancer risk when comparing irradiated patients with the expected numbers in a relevant population [32,33,34,35]. Conversely, a previous study by Bhojani et al [16] presented a significantly increased secondary cancer risk in the bladder (HR = 1.4, p = 0.02), rectum (HR = 2.1, p < 0.001) and lung (HR = 2.0, p = 0.004) in patients receiving external beam RT versus radical prostatectomy. With respect to other malignancies which were addressed by Hinnen et al [17] only, no significantly increased risk was observed in the RT group.…”

Section: Discussionmentioning

confidence: 99%

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Radiation-Induced Secondary Malignancy in Prostate Cancer: A Systematic Review and Meta-Analysis

et al. 2014

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Objective: To investigate the risk of radiation-induced secondary malignancy in patients with prostate cancer. Methods: We identified 690 references from PubMed, Embase and the Cochrane Library before August 1, 2012, that reported secondary malignancy in patients with prostate cancer after receiving radiation therapy (RT), and finally four studies were included. We calculated summary estimates using random-effects meta-analysis. Results: The overall standardized incidence ratio (SIR) of secondary malignancy in patients with prostate cancer receiving RT to the general population was 1.14 (95% CI 1.04-1.32). In the subgroup analysis, no increment in radiation-induced secondary malignancy risk was detected. In terms of SIR with different follow-up intervals, there was no difference in SIR (>6 months; <5 years) (SIR = 1.19, 95% CI 0.75-1.89) and SIR (>5 years; <10 years) (SIR = 1.39, 95% CI 0.87-2.23). When the follow-up extended to >10 years, a significantly increased secondary malignancy risk was observed (SIR = 1.45, 95% CI 1.23-1.72). There is no significantly increased secondary malignancy risk in patients receiving no RT. Conclusion: RT is associated with increased secondary malignancy in patients with prostate cancer; this effect only become conspicuous more than 10 years after treatment.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Radiation-Induced Secondary Malignancy in Prostate Cancer: A Systematic Review and Meta-Analysis

et al. 2014

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“…On the other hand, controversies still remain regarding the relationship between prostate radiation treatment and colorectal cancer. Some authors found that prostate radiation treatment resulted in an increased risk of developing colorectal cancer [12], rectal cancer only [13][14][15][16][17], or colon cancer only [12] while others concluded that there was no association [9,12,18]. Even studies using the Surveillance, Epidemiology, and End Results (SEER) database revealed contradictory results for rectal cancer [8,18,19].…”

Section: Introductionmentioning

confidence: 99%

Secondary Cancers After Radiation Therapy for Primary Prostate or Rectal Cancer

Lee

Hsieh

et al. 2015

World j. surg.

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Literature about the risk of secondary cancer after radiation therapy (RT) of prostate and rectal cancer reveals contradictory results. We conducted a meta-analysis to examine whether the RT induces secondary rectal or prostate cancer in patients, respectively, with prostate or rectal cancer. All studies published in Medline or Pubmed up to March 3, 2015, containing RT of primary rectal or prostate cancer, and providing risk estimates of secondary prostate or rectal cancer were considered as eligible. Relative risk (RR) and standardized incidence ratios (SIR) were calculated using the random-effects model. Twenty studies met the inclusion criteria. 12 of them were from the Surveillance, Epidemiology, and End Results (SEER) database. For prostate cancer patients, pooled adjusted RRs or SIRs did not show an effect on the risk of secondary rectal cancer. However, notwithstanding the limitations of SEER-based studies, the subgroup of prostate cancer patients receiving external beam radiation therapy (EBRT) showed an increased risk of rectal cancer. For rectal cancer patients, pooled adjusted RR of prostate cancer was 1.12 (95 % CI, 0.44-2.8) and SIR was 0.40 (95 % CI, 0.29-0.55). All studies included in the SIR analysis of rectal cancer were derived from the SEER data source. Based on current evidence, RT for prostate cancer patients had no effect on rectal cancer incidence, except for patients who received EBRT therapy. However, compared with the general population, RT for rectal cancer is associated with a decreased prostate cancer risk as found in SEER-based studies.

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“…However, the results of studies carried out to investigate this risk are contradictory. A recent study estimated that the hazard ratio of developing a rectal tumour at 120 months was 2.2 in patients treated with radiotherapy compared with the general population [11]. In contrast, a Canadian study evaluated all prostate cancer cases treated in British Columbia from 1984 to 2000 and found no signifi cant difference between observed and expected second cancer rates, whether treatment included radiotherapy or not [12].…”

mentioning

confidence: 98%

Treatment of localised prostate cancer with radiation therapy: evidence versus opinion

Guedea

Ramos²,

Herruzo³

et al. 2010

Clin Transl Oncol

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The Rate of Secondary Malignancies After Radical Prostatectomy Versus External Beam Radiation Therapy for Localized Prostate Cancer: A Population-Based Study on 17,845 Patients

Cited by 86 publications

References 34 publications

Radiation-Induced Secondary Malignancy in Prostate Cancer: A Systematic Review and Meta-Analysis

Radiation-Induced Secondary Malignancy in Prostate Cancer: A Systematic Review and Meta-Analysis

Secondary Cancers After Radiation Therapy for Primary Prostate or Rectal Cancer

Treatment of localised prostate cancer with radiation therapy: evidence versus opinion

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