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Prognostic impact of synchronous second primary malignancies on the overall survival of patients with metastatic prostate cancer

 Kyo Chul Koo  ;  Hanna Yoo  ;  Byung Ha Chung  ;  Seung Choul Yang  ;  Sung Joon Hong  ;  Koon Ho Rha  ;  Kyung Seok Han  ;  Sang Un Park  ;  Ki Hong Kim 
 JOURNAL OF UROLOGY, Vol.193(4) : 1239-1244, 2015 
Journal Title
Issue Date
Humans ; Male ; Neoplasm Metastasis ; Neoplasms, Second Primary/mortality* ; Prognosis ; Prostatic Neoplasms/mortality* ; Prostatic Neoplasms/pathology* ; Retrospective Studies ; Risk ; Survival Rate
mortality ; multiple primary ; neoplasm metastasis ; neoplasms ; prognosis ; prostatic neopla는
PURPOSE: We determined the prognostic impact of a synchronous second primary malignancy on overall survival in patients with metastatic prostate cancer. Identifying features that stratify the risk of overall survival is critical for judiciously applying definitive therapy. MATERIALS AND METHODS: We retrospectively analyzed the records of 582 consecutive patients with prostate cancer diagnosed with metastasis between May 7, 1998 and August 27, 2011. Patient age, body mass index, ECOG performance status, Charlson comorbidity index, prostate specific antigen, T and N stages, Gleason and ASA® scores, progression to castration resistant prostate cancer, prior local treatments and synchronous second primary malignancies at metastasis were assessed. A synchronous second primary malignancy was defined as a cytologically or histologically proven solid malignancy. Cox proportional hazards regression analysis was done to estimate overall survival by second primary type and evaluate predictive variables. RESULTS: A total of 164 patients (28.1%) had a synchronous second primary malignancy, of which colorectal (9.1%), stomach (7.3%) and lung (7.1%) cancers were the most prevalent types. During a median followup of 34.1 months patients without a synchronous second primary malignancy had a significantly higher overall survival rate than those with lung or stomach cancer. However, men without a second malignancy had outcomes comparable to those in men with colorectal cancer. Clinical stage T4 or greater, ASA score 1 or greater and lung or stomach cancer were independent predictors of overall mortality. CONCLUSIONS: A substantial proportion of patients with metastatic prostate cancer present with a synchronous second primary malignancy. Definitive therapy targeting prostate cancer may confer a limited survival benefit in patients with synchronous lung or stomach cancer.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Koo, Kyo Chul(구교철) ORCID logo https://orcid.org/0000-0001-7303-6256
Kim, Ki Hong(김기홍)
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Park, Sang Un(박상언)
Yang, Seung Choul(양승철)
Yoo, Han Na(유한나)
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
Han, Kyung Seok(한경석)
Hong, Sung Joon(홍성준) ORCID logo https://orcid.org/0000-0001-9869-065X
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