The Effect of 10 Most Common Nonurological Primary Cancers on Survival in Men With Secondary Prostate Cancer

Frontiers in Oncology, Vol. 11 (2021)

Keywords
Authors
  • Mike Wenzel
  • Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany
  • Mike Wenzel
  • Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada
  • Luigi Nocera
  • Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada
  • Luigi Nocera
  • Department of Urology and Division of Experimental Oncology, Urological Research Institute (URI), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
  • Christoph Würnschimmel
  • Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada
  • Christoph Würnschimmel
  • Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
  • Claudia Collà Ruvolo
  • Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada
  • Claudia Collà Ruvolo
  • Department of Neurosciences, University of Naples Federico II Reproductive Sciences and Odontostomatology, Naples, Italy
  • Zhe Tian
  • Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada
  • Fred Saad
  • Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada
  • Alberto Briganti
  • Department of Urology and Division of Experimental Oncology, Urological Research Institute (URI), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
  • Derya Tilki
  • Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
  • Derya Tilki
  • Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
  • Markus Graefen
  • Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
  • Andreas Becker
  • Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany
  • Frederik C. Roos
  • Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany
  • Felix K. H. Chun
  • Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany
  • Pierre I. Karakiewicz
  • Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada

Abstract

BackgroundThis study aims to test the effect of the 10 most common nonurological primary cancers (skin, rectal, colon, lymphoma, leukemia, pancreas, stomach, esophagus, liver, lung) on overall mortality (OM) after secondary prostate cancer (PCa).Material and MethodsWithin the Surveillance, Epidemiology, and End Results (SEER) database, patients with 10 most common primary cancers and concomitant secondary PCa (diagnosed 2004–2016) were identified and were matched in 1:4 fashion (age, year at diagnosis, race/ethnicity, treatment type, TNM stage) with primary PCa controls. OM was compared between secondary and primary PCa patients and was stratified according to primary cancer type, as well as according to time interval between primary cancer vs. secondary PCa diagnoses.ResultsWe identified 24,848 secondary PCa patients (skin, n = 3,871; rectal, n = 798; colon, n = 3,665; lymphoma, n = 2,583; leukemia, n = 1,102; pancreatic, n = 118; stomach, n = 361; esophagus, n = 219; liver, n = 160; lung, n = 1,328) vs. 531,732 primary PCa patients. Secondary PCa characteristics were less favorable than those of primary PCa patients (PSA and grade), and smaller proportions of secondary PCa patients received active treatment. After 1:4 matching, all secondary PCa exhibited worse OM than primary PCa patients. Finally, subgroup analyses showed that the survival disadvantage of secondary PCa patients decreased with longer time interval since primary cancer diagnosis and subsequent secondary PCa.ConclusionPatients with secondary PCa are diagnosed with less favorable PSA and grade. Even after matching for PCa characteristics, secondary PCa patients still exhibit worse survival. However, the survival disadvantage is attenuated, when secondary PCa diagnosis is made after longer time interval, since primary cancer diagnosis.

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