External beam radiotherapy for prostate cancer increases bladder-cancer risk

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By Will Boggs MD

NEW YORK (Reuters Health) - Men whose prostate cancer is treated with external beam radiotherapy (EBRT) could face a higher risk of bladder cancer than those treated with radical prostatectomy, according to a database study.

"Physicians should recognize this risk factor for bladder cancer, especially in patients with concomitant risk factors (for example, smoking history)," Dr. Marco Moschini of the Medical University of Vienna told Reuters Health by email.

Dr. Moschini and colleagues used data from the U.S. National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER)-Medicare insurance program-linked database to investigate the impact of treatment of primary prostate cancer on the subsequent risk of developing a second primary bladder cancer or rectal cancer.

Among more than 84,000 men with localized prostate cancer included in the study, 39% were treated with radical prostatectomy and 61% were treated with EBRT.

The five- and 10-year cumulative bladder-cancer incidence rates were significantly higher in men treated with EBRT (1.26% and 2.34%, respectively) than in men treated with radical prostatectomy (0.75% and 1.63%, respectively), the team reports in European Urology, online October 4.

In multivariable analyses, men treated with EBRT were 35% more likely to develop bladder cancer than were men treated with radical prostatectomy (P<0.001).

In contrast, rectal cancer incidence rates did not differ significantly between the treatment groups.

Men treated with EBRT were also 27% more likely than men treated with radical prostatectomy to develop a second primary pelvic cancer.

"Physicians should consider these results to counsel patients diagnosed with prostate cancer with the right treatment," Dr. Moschini said.

"Further studies reporting the outcomes of contemporary patients treated with EBRT, especially well-designed randomized prospective trials, are urgently required to confirm our findings," the researchers note.

SOURCE: https://bit.ly/2yMs7ec

Eur Urol 2018.

(c) Copyright Thomson Reuters 2018. Click For Restrictions - https://ift.tt/2JukZpL
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