Multiple primary malignancies in patients with prostate cancer: increased risk of secondary malignancies after radiotherapy

Abstract

New treatment strategies for prostate cancer have recently been developed, but multiple malignancies remain a major concern. The aim of this study was to evaluate the characteristics of multiple malignancies and to analyze the risk of secondary malignancies after radiotherapy for prostate cancer. From 2000 to 2011, 150 patients with prostate cancer were treated with curative radiotherapy in our department. Patient age range was 54-92years (median, 70years), and the follow-up period was 4-142months (median, 48months). The incidence of multiple primary cancers was compared with the estimated incidence. A total of 147 patients (98%) survived more than 12months (12-142months; median, 48months); 20/150 patients (13%) died within 10years. Cause of death was recurrent prostate cancer in 11 patients, other primary malignancies in 7 patients, and cardiovascular disease in 2 patients. Multiple primary cancers were present in 26 of 150 patients (17%), including 16 subsequent malignancies (11%) with latent periods of 13-83months (median, 43months). The subsequent non-prostate malignancies were lung cancer in 4 patients, urinary bladder or ureter cancer in 4, stomach cancer in 3, malignant lymphoma in 2, and other in 3. Analysis of the observed incidence of secondary malignancies compared with the estimated incidence in the general population revealed a higher incidence of ureter cancer and malignant lymphoma. Close attention should be paid to secondary malignancies after radiotherapy for prostate cancer, including malignancies occurring within 5years, which could be attributable to radiotherapy.