The effect of primary urological cancers on survival in men with secondary prostate cancer

  • Background: To test the effect of urological primary cancers (bladder, kidney, testis, upper tract, penile, urethral) on overall mortality (OM) after secondary prostate cancer (PCa). Methods: Within the Surveillance, Epidemiology and End Results (SEER) database, patients with urological primary cancers and concomitant secondary PCa (diagnosed 2004-2016) were identified and were matched in 1:4 fashion with primary PCa controls. OM was compared between secondary and primary PCa patients and stratified according to primary urological cancer type, as well as to time interval between primary urological cancer versus secondary PCa diagnoses. Results: We identified 5,987 patients with primary urological and secondary PCa (bladder, n = 3,287; kidney, n = 2,127; testis, n = 391; upper tract, n = 125; penile, n = 47; urethral, n = 10) versus 531,732 primary PCa patients. Except for small proportions of Gleason grade group and age at diagnosis, PCa characteristics between secondary and primary PCa were comparable. Conversely, proportions of secondary PCa patients which received radical prostatectomy were smaller (29.0 vs. 33.5%), while no local treatment rates were higher (34.2 vs. 26.3%). After 1:4 matching, secondary PCa patients exhibited worse OM than primary PCa patients, except for primary testis cancer. Here, no OM differences were recorded. Finally, subgroup analyses showed that the survival disadvantage of secondary PCa patients decreased with longer time interval since primary cancer diagnosis. Conclusions: After detailed matching for PCa characteristics, secondary PCa patients exhibit worse survival, except for testis cancer patients. The survival disadvantage is attenuated, when secondary PCa diagnosis is made after longer time interval, since primary urological cancer diagnosis.

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Author:Mike WenzelORCiDGND, Christoph WürnschimmelORCiDGND, Luigi NoceraORCiD, Claudia Collà RuvoloORCiD, Zhe Tian, Fred SaadORCiDGND, Alberto BrigantiORCiD, Derya TilkiORCiDGND, Markus GraefenORCiDGND, Frederik RoosGND, Philipp MandelORCiDGND, Felix ChunORCiDGND, Pierre I. Karakiewicz
Parent Title (English):The prostate
Place of publication:New York, NY
Document Type:Article
Date of Publication (online):2021/09/23
Date of first Publication:2021/08/16
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2021/12/20
Tag:bladder cancer; kidney cancer; mortality; primary prostate cancer; urological cancer
Page Number:10
First Page:1
Last Page:10
Open Access funding enabled and organized by Projekt DEAL.
Early View: Online Version before inclusion in an issue
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Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (English):License LogoCreative Commons - Namensnennung-Nicht kommerziell 4.0