Prostate radiotherapy and the risk of secondary rectal cancer—a meta-analysis

Nugent, Timothy; Low, Ernest Z; Fahy, Matthew; Donlon, Noel E; McCormick, Paul; Mehigan, Brian; Cunningham, Moya; Gillham, Charles; Kavanagh, Dara; Kelly, Michael E.; Larkin, John

doi:10.1007/s00384-021-04075-6

Cited by 6 publications

(5 citation statements)

References 62 publications

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“…The increase in the incidence of MPMTs can be attributed to the increased number of cancer survivors, the long-term side effects of chemotherapy and radiotherapy, and the role of genetic, environmental, and endocrine factors[ 11 ]. The results of a meta-analysis showed that patients with prostate cancer treated with radiotherapy have an increased risk (OR) of developing rectal cancer compared with patients treated with non-radiotherapy measures (OR: 1.45, 95%CI: 1.07-1.97, P = 0.02)[ 12 ]. This suggests that radiation therapy may increase the risk of a second primary malignancy.…”

Section: Discussionmentioning

confidence: 99%

Heterochronous multiple primary prostate cancer and lymphoma: A case report

Liang,

Bu,

Peng

et al. 2024

World J Clin Cases

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BACKGROUND Multiple primary malignant tumors (MPMTs) are rare type of cancer, especially when solid tumors are the first and lymphoma is the second primary malignancy. We report a patient with heterochronous MPMTs consisting of prostate cancer and rectal diffuse large B-cell lymphoma (DLBCL). CASE SUMMARY We report a 77-year-old male patient diagnosed with prostate cancer who was treated with radiation therapy and one year of endocrine therapy with bicalutamide (50 mg per day) and an extended-release implant of goserelin (1/28 d). Seven years later, rectal DLBCL with lung metastases was found. CONCLUSION Although rare, the possibility of prostate cancer combined with a double primary cancer of DLBCL can provide a deeper understanding.

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Section: Discussionmentioning

confidence: 99%

Heterochronous multiple primary prostate cancer and lymphoma: A case report

Liang,

Bu,

Peng

et al. 2024

World J Clin Cases

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“…On average, prostate cancer is diagnosed in older patients (approximately 70 years) compared with rectal cancer (over 60 years) ( 2 , 17 ). In addition, radiotherapy itself can induce secondary rectal cancer ( 4 – 7 ). Rombouts et al ( 5 ) published in their population-based study from the Netherlands a median interval of 6 years from pelvic radiotherapy to rectal cancer.…”

Section: Discussionmentioning

confidence: 99%

“…The curative treatment options for prostate cancer (PC) are limited to either prostatectomy or radiotherapy ( 3 ). However, patients who have received radiotherapy for pelvic cancer have an increased risk for rectal cancer ( 4 – 7 ). Studies have demonstrated that neoadjuvant radiotherapy decreases the risk of local recurrence in stage II and III mid and low rectal cancer ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Surgical and oncological results after rectal resections with or without previous treatment for prostate cancer

Tomminen,

Huhtala,

Kotaluoto

et al. 2024

Front. Surg.

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IntroductionPrevious treatment for prostate cancer (PC) may potentially affect the surgical and oncological outcomes of subsequent rectal cancer surgery, but there are only a few studies regarding this particular group. In this study, we present the 3-year surgical and oncological results of rectal cancer patients who had received previous treatment for PC at a single Finnish tertiary referral centre.Material and methodsData regarding all male patients diagnosed with rectal cancer and treated at Tampere University Hospital (TAUH) between 1997 and 2016 were gathered from medical records. In total, this study included 553 rectal cancer patients who underwent curative surgery, and 54 of them (9.8%) had a prior history of treatment for prostate cancer.ResultsPatients in the PC group were older and had more comorbidities compared with those in the non-PC group. The PC patients had a significantly higher risk of permanent stoma compared with the non-PC patients (61.5% vs. 45.2%, respectively, p = 0.025). The PC patients seemed to have lower tumours than the non-PC patients (87% vs. 75%, respectively, p = 0.05). Overall, the 3-year overall survival (OS) for the PC and non-PC patients was 74.1% and 80.6%, respectively. No significant differences were observed between the study groups even in the age-adjusted comparison [hazard ratio (HR): 1.07, confidence interval (CI) 95%: 0.60–1.89]. In the univariable analysis, radically operated patients without a history of PC exhibited an improved overall survival, (HR: 2.46, 95% CI: 1.34–4.53, p = 0.004). However, only a higher age-adjusted Charlson comorbidity index (CCI) and a low tumour location (<10 cm) were found to have an independent prognostic impact on worse OS in the multivariable analysis (HR: 1.57, 95% CI: 1.36–1.82, p < 0.001 and HR: 2.74, 95% CI: 1.32–5.70, p = 0.007, respectively). No significant differences were observed between the groups in terms of disease-free or local recurrence-free survival.ConclusionRectal cancer is more frequently found in the middle or lower part of the rectum in patients who have previously received treatment for prostate cancer. These patients also have a higher likelihood of requiring a permanent stoma. In radically operated rectal cancer, the PC group had a worse OS rate, according to the univariable analysis. However, the only independent prognostic factors for a worse OS that were highlighted in the multivariable analysis included a higher CCI and a low tumour location.

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“…Jahreiß MC et al found that the risk of second primary cancer in prostate cancer patients with external beam radiotherapy (EBRT) was increased and remained throughout the different EBRT eras [ 17 ]. A meta-analysis also indicated that prostate radiotherapy significantly increases the risk of subsequent rectal cancer [ 18 ]. Combined with our study results, we found that in a variety of cancers, the proportion of patients with second primary thyroid cancer is prone to increase after RT, which may be consistent with the current scientific reports that RT tends to increase the incidence of thyroid cancer.…”

Section: Discussionmentioning

confidence: 99%

Radiation Therapy Changed the Second Malignancy Pattern in Rectal Cancer Survivors

Tan

et al. 2023

Medicina

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Background and Objectives: Radiotherapy (RT) plays an important role in the treatment for locally advanced rectal cancer patients. It can bring radio exposure together with the survival benefit. Cancer survivors are generally at an increased risk for second malignancies, and survivors receiving RT may have higher risks than survivors not receiving RT. Whether the risk of an all-site second malignancy may increase after RT is still debated. This study aims to compare the second malignancy pattern in rectal cancer survivors after RT. Materials and Methods: The Surveillance, Epidemiology, and End Results (SEER) database was used for analysis. In total, 49,961 rectal cancer patients (20–84 years of age) were identified between 2000 and 2012 from 18 SEER registries. All patients underwent surgery. The occurrence of second malignancies diagnosed after rectal cancer diagnosis was compared in patients who received and did not receive RT. The standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) were used. SEER*Stat was used to generate the 95% CIs for the SIR statistics using the exact method. Results: Of the total 49,961 patients, 5582 developed second malignancies. For all-site second primary malignancies, the age-adjusted SIRs were 1.14 (95% CI 1.1–1.18) and 1.00 (95% CI 0.96–1.04) in the no RT and RT groups, respectively. In 23,192 patients from the surgery-only group, 2604 had second malignancies, and in 26,769 patients who received RT, 2978 developed second malignancies. With respect to every site, the risk of secondary prostate cancer was significantly lower in the RT group (SIR = 0.39, 95% CI 0.33–0.46) than that in the surgery-only group (SIR = 1.04, 95% CI 0.96–1.12). Moreover, the risk of thyroid cancer was significantly higher in the RT group (SIR = 2.80, 95% CI 2.2–3.51) than that in the surgery-only group (SIR = 1.29, 95% CI 0.99–1.66). Conclusions: RT may change the second malignancy pattern in rectal cancer survivors; the risk of prostate cancer decreased, and the risk of thyroid cancer increased most significantly.

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Prostate radiotherapy and the risk of secondary rectal cancer—a meta-analysis

Cited by 6 publications

References 62 publications

Heterochronous multiple primary prostate cancer and lymphoma: A case report

Heterochronous multiple primary prostate cancer and lymphoma: A case report

Surgical and oncological results after rectal resections with or without previous treatment for prostate cancer

Radiation Therapy Changed the Second Malignancy Pattern in Rectal Cancer Survivors

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