Bladder cancer incidence and risk factors in men with prostate cancer: Results from cancer of the prostate strategic urologic research endeavor
Bladder cancer incidence and risk factors in men with prostate cancer: Results from cancer of the prostate strategic urologic research endeavor
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DOI：
10.1016/j.juro.2006.10.071
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发表时间：
2007-03-01
影响因子：
6.6
通讯作者：
Kane, Christopher J.
中科院分区：
文献类型：
--
作者：
Boorjian, Stephen;Cowan, Janet E.;Kane, Christopher J.
目的：我们评估了一个大型的疾病登记处，以确定前列腺癌患者膀胱癌的发病率，并调查是否前列腺癌的治疗类型增加膀胱cancer.Materials和方法的风险：我们分析了CaPSURE（TM）疾病登记处诊断为前列腺癌加膀胱癌的男性在1989年和2003年之间。比较了膀胱癌患者和非膀胱癌患者的人口统计学、合并症和前列腺癌治疗方式。采用后向逐步考克斯比例风险回归模型预测前列腺癌治疗后30天或更长时间内发生膀胱癌的患者在前列腺癌治疗后发生膀胱癌。膀胱癌和前列腺癌患者年龄较大（p < 0.01），更可能是白色（p = 0.03），他们的收入水平（p < 0.01）和教育水平（p = 0.04）低于仅患前列腺癌的患者。合并症在膀胱癌患者和非膀胱癌患者之间没有差异。接受根治性膀胱切除术的患者发生治疗后膀胱癌的可能性约为接受放射治疗的患者的一半（HR 0.51，95% CI 0.29-0.89）。吸烟患者膀胱癌风险独立增加（HR 2.08，95%CI 1.09-3.97），而接受放射治疗的吸烟者膀胱癌风险增加近4倍（HR 3.65，95%CI 1.45-9.16）。结论：前列腺癌患者膀胱癌的发病率为1.5%。放射治疗和吸烟会增加患膀胱癌的风险。
Purpose: We evaluated a large disease registry to determine the incidence of bladder cancer in patients with prostate cancer and investigate whether the type of treatment for prostate cancer increased the risk of bladder cancer.Materials and Methods: We analyzed the CaPSURE (TM) disease registry for men diagnosed with prostate cancer plus bladder cancer between 1989 and 2003. Demographics, comorbidities and prostate cancer treatment modalities were compared in patients with and without bladder cancer. A backward stepwise Cox proportional hazards regression model was used to predict bladder cancer onset after treatment for prostate cancer in patients who had bladder cancer 30 days or greater after prostate cancer treatment.Results: Of 9,780 patients from CaPSURE 143 (1.46%) also had bladder cancer. Patients with bladder cancer and prostate cancer were older (p < 0.01) and more likely to be white (p = 0.03), and they had lower levels of income (p < 0.01) and education (p = 0.04) than patients with prostate cancer only. Comorbidities did not differ between patients with and without bladder cancer. Patients treated with radical prostatectomy were approximately half as likely to have posttreatment bladder cancer as patients who underwent radiation therapy (HR 0.51, 95% CI 0.29-0.89). Patients who smoked had an independent increase in the risk of bladder cancer (HR 2.08, 95% CI 1.09-3.97), while smokers treated with radiation therapy were at almost 4-fold risk for bladder cancer (HR 3.65, 95% Cl 1.45-9.16).Conclusions: The incidence of bladder cancer in patients with prostate cancer was 1.5%. Radiation therapy and smoking increased the risk of bladder cancer.