PD21-12 SECOND PRIMARY MALIGNANCY RELATED MORTALITY IN MEN TREATED WITH RADICAL PROSTATECTOMY FOR LOCALIZED PROSTATE CANCER: AN INSIGHT INTO PROSTATE CANCER SURVIVORSHIP AT 15-YEARS OF FOLLOW-UP

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD21-12 SECOND PRIMARY MALIGNANCY RELATED MORTALITY IN MEN TREATED WITH RADICAL PROSTATECTOMY FOR LOCALIZED PROSTATE CANCER: AN INSIGHT INTO PROSTATE CANCER SURVIVORSHIP AT 15-YEARS OF FOLLOW-UP Akshay Sood, Ralph Grauer, Mireya Diaz-Insua, Firas Abdollah, and Mani Menon Akshay SoodAkshay Sood More articles by this author , Ralph GrauerRalph Grauer More articles by this author , Mireya Diaz-InsuaMireya Diaz-Insua More articles by this author , Firas AbdollahFiras Abdollah More articles by this author , and Mani MenonMani Menon More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003287.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: A high life-expectancy in men following treatment of prostate cancer (PCa) has brought into focus post-therapy survivorship. In this report, we examined the ultimate cause of death in men with localized PCa treated with upfront radical prostatectomy (RP), with a focus on second primary malignancy (SPM)-related mortality. METHODS: Overall, 6,067 men that underwent robotic RP between September 2001 and December 2013 and were eligible for >5 years of follow-up were included in the study. Patients were stratified by burden of comorbidity (age-adjusted Charlson comorbidity index [aa-CCI]) and postoperative tumor-specific risk (Diaz classification [risk-groups 1-5]), and mortality from PCa, SPM, cardio-cerebrovascular disease, and other/unknown causes was estimated using competing-risk cumulative incidence analysis. RESULTS: The median follow-up was 8.2 years. At 15-years, 2.0% of all patients had died from a SPM. All-cause mortality at 15-years was 7.6%. SPMs were the leading cause of death in healthy men (aa-CCI ≤3) with low-to-intermediate risk disease (Diaz risk-groups ≥3), with 1.1 to 4.4% of these patients dying of SPMs during the study-period. In contrast, only 0.1 to 0.2% of these patients died of PCa and 1.1 to 3.7% of cardio-cerebrovascular disease (Figure). The top three most lethal SPMs were lung, pancreatic, and liver cancers. Standardized mortality ratio (SMR) analysis demonstrated that SPM-related mortality in PCa survivors was higher than that in the general public (2- to 12-fold higher, depending on SPM). Family history of prostate or other cancers and/or use of post-RP radiation/hormone therapy were not associated with increased risk of SPM mortality. CONCLUSIONS: Prostate cancer survivors, especially those in good health, may be at increased risk for death from second primary malignancies and may benefit from tailored cancer screening programs. These data require further validation -- if verified, may have important implications with regards to long-term surveillance of PCa survivors. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e595 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Akshay Sood More articles by this author Ralph Grauer More articles by this author Mireya Diaz-Insua More articles by this author Firas Abdollah More articles by this author Mani Menon More articles by this author Expand All Advertisement PDF downloadLoading ...