Abstract
Radiotherapy for prostate cancer is associated with an increased incidence of secondary bladder cancer (BC). We investigated the incidence, clinicopathological characteristics, and prognosis of BC after radiotherapy, surgical therapy, and primary androgen-deprivation therapy (ADT) for prostate cancer. This study included 1,334 Japanese patients with prostate cancer treated with radiotherapy (n=631), surgical therapy (n=437), and primary ADT (n=266). During the median follow-up period of 51.2, 44.8, and 45.5 months, secondary BC occurred in 14 (2.2%), 5 (1.1%), and 0 (0%) of patients with prostate cancer treated with radiotherapy, surgical therapy, and primary ADT, respectively. The 10-year BC-free survival rate was 91.3% in the radiotherapy group, 97.4% in the surgical therapy group, and 100% in the primary ADT group. The rates of intravesical recurrence, progression to muscle-invasive BC, and BC-specific death might be higher in secondary BC after radiotherapy compared with after surgical therapy. There was a significant difference in the incidence of secondary BC among different therapeutic modalities for prostate cancer in Japanese men, indicating significantly lower comorbidity rates of secondary BC after primary ADT for prostate cancer compared with radiotherapy.
Highlights
Prostate cancer is one of the most common cancers among men of developed countries
With regard to therapeutic modalities, 23 men (3.6%), 11 men (2.5%), and 15 men (5.6%) among patients treated with radiotherapy, surgical therapy, and primary androgen-deprivation therapy (ADT), were diagnosed with bladder cancer (BC), respectively
During the median follow-up period of 44.8 (IQR, 24.4–77.7) and 45.5 (IQR, 26.1–71.3) months, five (1.1%) men or no men among patients treated with surgical treatment or ADT were diagnosed with secondary BC with a median latency of 65.8 (IQR, 19.8–116.0) months, respectively
Summary
Prostate cancer is one of the most common cancers among men of developed countries. In the United States, it is estimated that about 233,000 men will develop, and about 29,480 men will die, from prostate cancer in 2014 [1]. Several therapeutic modalities are available and apply to patients with prostate cancer according to various clinicopathological parameters. Salvage radiotherapy is a common therapeutic option for biochemical recurrence after RP along with salvage androgen-deprivation therapy (ADT). ADT inhibiting androgen receptor (AR) signaling by either surgical or medical castration and/or anti-androgen agents is the gold standard for advanced or metastatic prostate cancer. Among these therapeutic modalities, physicians and patients can choose the best single option or combination. As patients with prostate cancer are expected to live longer compared with those with other cancers, late-phase adverse events are more meaningful and critical. Numerous studies have reported the oncological outcomes using these modalities, reports on adverse events, especially late-phase events, are relatively limited
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