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

Authors
 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 
Citation
 Journal of Urology, Vol.193(4) : 1239-1244, 2015 
Journal Title
 Journal of Urology 
ISSN
 0022-5347 
Issue Date
2015
Abstract
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.
Full Text
http://www.sciencedirect.com/science/article/pii/S0022534714047697
DOI
10.1016/j.juro.2014.10.088
Appears in Collections:
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
구교철(Koo, Kyo Chul) ORCID logo https://orcid.org/0000-0001-7303-6256
김기홍(Kim, Ki Hong)
나군호(Rha, Koon Ho) ORCID logo https://orcid.org/0000-0001-8588-7584
박상언(Park, Sang Un)
양승철(Yang, Seung Choul)
유한나(Yoo, Han Na)
정병하(Chung, Byung Ha) ORCID logo https://orcid.org/0000-0001-9817-3660
한경석(Han, Kyung Seok)
홍성준(Hong, Sung Joon) ORCID logo https://orcid.org/0000-0001-9869-065X
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/139145
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