Risk of Second Primary Tumors in Men Diagnosed With Prostate Cancer
Risk of Second Primary Tumors in Men Diagnosed With Prostate Cancer
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DOI：
10.1002/cncr.28769
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发表时间：
2014-09-01
期刊：
影响因子：
6.2
通讯作者：
Cooney, Kathleen A.
中科院分区：
文献类型：
--
作者：
Davis, Elizabeth J.;Beebe-Dimmer, Jennifer L.;Cooney, Kathleen A.
背景：诊断为前列腺癌的男性的生存率随着时间的推移而提高，目前的10年相对生存率为99.7%。这种常见癌症患者的长期生存提出了关于第二原发癌风险和持续监测的必要性的问题。方法：从监测、流行病学和最终结果计划（SEER）数据（SEER 13）中确定了1992年至2010年期间诊断为前列腺癌的441，504名男性的基于人群的队列。标准化发病率比（SIR）计算为基于一般人群发病率的第二原发恶性肿瘤风险估计值。研究结果：与美国人群相比，前列腺癌幸存者总体上被诊断为另一种癌症的风险较低（SIR = 0.60; 95%置信区间，0.60-0.61）。患白血病和口腔癌、咽癌、食道癌、胃癌、结肠癌、直肠癌、肝癌、胆囊癌、胰腺癌、肺癌、支气管癌和喉癌的风险明显较低。相反，这些患者患膀胱癌、肾癌、内分泌癌和软组织癌的风险更高。与未接受放射治疗的男性相比，接受放射治疗（外束放射治疗）的男性患膀胱癌（SIR = 1.42）和直肠癌（SIR = 1.70）的风险长期增加（SIR膀胱= 0.76; SIR直肠= 0.74）。被诊断为第二原发性癌症的风险存在显着的种族差异，这些风险的大小和方向取决于肿瘤类型。结论：前列腺癌幸存者仍有后续恶性肿瘤的风险，种族和治疗选择是长期风险的重要决定因素。(C)2014年美国癌症协会
BACKGROUND: The survival of men diagnosed with prostate cancer has improved over time, and the current 10-year relative survival rate is 99.7%. The long survival of patients with this common cancer raises questions about the risk of a second primary cancer and the need for continued surveillance. METHODS: A population-based cohort of 441,504 men who were diagnosed with prostate cancer between 1992 and 2010 was identified from Surveillance, Epidemiology and End Results Program (SEER) data (SEER13). The standardized incidence ratio (SIR) was calculated as an estimate of the risk of a second primary malignancy based on the incidence in the general population. RESULTS: Prostate cancer survivors had a lower risk of being diagnosed with another cancer overall compared with the US population (SIR = 0.60; 95% confidence interval, 0.60-0.61). The risks of leukemia and cancers of the oral cavity and pharynx, esophagus, stomach, colon and rectum, liver, gallbladder, pancreas, lung and bronchus, and larynx were significantly lower. Conversely, these patients had a greater risk of bladder, kidney, and endocrine and soft tissue cancers. Men who received treatment with radiation therapy (external-beam radiation therapy) had long-term increases in their risk of bladder cancer (SIR = 1.42) and rectal cancer (SIR = 1.70) risk compared with who did not receive radiation (SIRbladder = 0.76; SIRrectal = 0.74). There were significant racial differences in the risk of being diagnosed with a second primary cancer, and the magnitude and direction of these risks depended on tumor type. CONCLUSIONS: Prostate cancer survivors remain at risk of subsequent malignancies, and race and treatment choice important determinants of long-term risk. (C) 2014 American Cancer Society.