Bladder carcinoma and other second malignancies after radiotherapy for prostate carcinoma

Neugut, Alfred I.; Ahsan, Habibul; Robinson, Eliezer; Ennis, Ronald D.

doi:10.1002/(sici)1097-0142(19970415)79:8<1600::aid-cncr24>3.0.co;2-0

Cited by 192 publications

(125 citation statements)

References 16 publications

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“…23 BC tends to occur 5 to 10 years after radiation and is characteristically high grade and locally advanced at diagnosis. 24 The relative risk of secondary bladder malignancy ranges 1.5-to 4-fold and is likely proportional to the dose of radiation given.…”

Section: Cyclophosphamidementioning

confidence: 99%

Molecular Mechanisms and Pathways in Bladder Cancer Development and Progression

Jung

Messing

2000

Cancer Control

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Background: The basis for bladder cancer development and progression is complex and involves genetic abnormalities. These abnormalities yield phenotypic changes that allow normal transitional cells to becomeity of these new cases, approximately 75%, are limited to the mucosa (stage Ta or Tis) and lamina propria (T1) at presentation, and most of these tumors can be removed by transurethral resection. Recurrence rates are high (30% to 85%), and 10% to 30% of "superficial" tumors (T1 or less) will subsequently progress to muscle invasive disease (stages T2-T4), which has a poorer prognosis. 2 For the remaining 25%, the initial presentation involves muscle invasive disease that will usually relapse with metastases (as well as localized disease persistence) within a median of 2 years if managed only by transurethral resection and intravesical therapy. 3 These data support the heterogeneous nature and malignant potential of transitional cell carcinoma

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Section: Cyclophosphamidementioning

confidence: 99%

Molecular Mechanisms and Pathways in Bladder Cancer Development and Progression

Jung

Messing

2000

Cancer Control

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“…Moreover, the relatively short follow-up (ie, 42.3 months) of these patients highlights these results, excluding a confounding action of RT in the development of secondary primaries. [49][50][51] Obese men may need more extensive staging and closer follow-up to detect subsequent new malignancies. There are inherent limitations in this study that are important to underline.…”

Section: Discussionmentioning

confidence: 99%

Influence of abdominal adiposity, waist circumference, and body mass index on clinical and pathologic findings in patients treated with radiotherapy for localized prostate cancer

Zilli¹,

Chagnon²,

Nguyen³

et al. 2010

Cancer

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BACKGROUND: Increased body mass index (BMI) has been associated with more aggressive prostate cancer (PC). The relation among abdominal visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), waist circumference (WC), and BMI was compared with clinical and pathologic findings in patients treated with radiotherapy for localized PC. METHODS: VAT, SAT, WC (all measured by planning abdominopelvic computed tomography scan) and BMI were compared with clinical and pathologic factors using univariate analyses. Cox regression analyses were performed to evaluate whether obesity measures significantly predicted risk for secondary malignancies. RESULTS: Of 276 analyzed patients, 80 (29%) were obese (BMI ! 30 kg/m 2 ). Median BMI at baseline was 27.6 kg/m 2 (interquartile range [IQR], 25.1-30.5 kg/m 2 ). Increased SAT and VAT were associated with a higher National Comprehensive Cancer Network (NCCN) PC risk group (P ¼.0001 and .008, respectively). Greater SAT was associated with a higher Gleason score (GS) (P ¼.030). Younger age at diagnosis was significantly correlated with higher SAT and BMI, whereas increased prostate size was found in patients with higher BMI, WC, SAT, and VAT. At a median follow-up of 42.3 months (IQR, 32.3-59.9 months), 15 secondary malignancies were observed. On multivariate analysis, VAT was a significant predictor for secondary cancers (adjusted hazards ratio, 1.014; P ¼.0001). CONCLUSIONS: Measurements of greater abdominal adiposity were strongly associated with adverse pathologic features in patients with localized PC, including higher GS and NCCN PC risk groups. Moreover, VAT was found to be a strong risk factor for secondary malignancies. Cancer 2010;116:5650-8.

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“…9 Whether radiotherapy increases bladder cancer risk remains a subject of continued debate. 8,[10][11][12][13][14][15][16][17][18][27][28][29] The consequences of radiation exposure vary in different animals and even different strains of the same species, and in organs within a species. 23 The development of secondary cancer may not be related to radiotherapy, but rather may be explained by diagnostic bias, common etiologic factors, or by common pathway of carcinogenesis.…”

Section: Discussionmentioning

confidence: 99%

“…Specifically, there is controversy whether radiotherapy for prostate cancer leads to an increased risk of bladder cancer. [8][9][10][11][12][13][14][15][16][17][18] In 2006, we first reported that bladder cancer patients who had received radiotherapy for prostate cancer had higher grade disease and presented at a higher stage than nonirradiated patients. 19 We now update our cohort and review the pathological features and survival outcomes of bladder cancer patients previously treated with or without radiotherapy for prostate cancer.…”

Section: Introductionmentioning

confidence: 99%

Impact of Previous Radiotherapy for Prostate Cancer on Clinical Outcomes of Bladder Cancer Patients

Yee¹,

Shariat²,

Lowrance³

et al. 2009

Journal of Urology

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Purpose-The impact of prostate cancer radiotherapy on the biological behavior of bladder cancer remains unclear. We compared outcomes of bladder cancer patients previously treated for prostate cancer with radiotherapy versus other treatment modalities.Materials and Methods-We identified 144 patients diagnosed with bladder cancer between January 1992 and June 2007 with a previous prostate cancer diagnosis. Clinicopathologic data and outcomes were compared between irradiated (brachytherapy and/or external beam radiation therapy; n = 83) and nonirradiated (androgen deprivation therapy, radical prostatectomy, and/or surveillance; n = 61) patients.Results-Median time between prostate and bladder cancer diagnoses was longer in irradiated versus nonirradiated patients (59 months versus 24 months [IQR 2-87], p = 0.007). Irradiated patients presented with higher tumor grade (high: 92% versus 77%, p = 0.016) and progressed to higher stage (muscle-invasive: 70% versus 43%, p = 0.001) than nonirradiated patients. In patients undergoing cystectomy, irradiated patients had a numerically higher rate of non-organ confined disease (75% versus 56% for nonirradiated patients, p = 0.1). Among all bladder cancer patients, 5-year cancer-specific survival was 73% (95% CI 59-87) for irradiated patients versus 83% (95% CI 71-95) for nonirradiated patients (p = 0.07). Median followup was 53 months (IQR 24-75).Conclusions-More time elapsed between prostate and bladder cancer diagnoses for irradiated patients, and irradiated patients presented with more advanced disease. Future studies are needed to further establish clinical differences in bladder cancer between irradiated and nonirradiated patients and whether biological differences exist.

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Bladder carcinoma and other second malignancies after radiotherapy for prostate carcinoma

Cited by 192 publications

References 16 publications

Molecular Mechanisms and Pathways in Bladder Cancer Development and Progression

Molecular Mechanisms and Pathways in Bladder Cancer Development and Progression

Influence of abdominal adiposity, waist circumference, and body mass index on clinical and pathologic findings in patients treated with radiotherapy for localized prostate cancer

Impact of Previous Radiotherapy for Prostate Cancer on Clinical Outcomes of Bladder Cancer Patients

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