Multi-Institutional Analysis of Synchronous Prostate and Rectosigmoid Cancers
Purpose: To perform a multi-institutional analysis of patients with synchronous prostate and rectosigmoid cancers.Materials and Methods: A retrospective review of Duke University and Durham Veterans Affairs Medical Center records was performed for men with both prostate and rectosigmoid adenocarcino...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-03-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fonc.2020.00345/full |
| _version_ | 1818062270204215296 |
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| author | Corbin D. Jacobs Jacob Trotter Manisha Palta Manisha Palta Michael J. Moravan Michael J. Moravan Yuan Wu Christopher G. Willett W. Robert Lee W. Robert Lee Brian G. Czito Brian G. Czito |
| author_facet | Corbin D. Jacobs Jacob Trotter Manisha Palta Manisha Palta Michael J. Moravan Michael J. Moravan Yuan Wu Christopher G. Willett W. Robert Lee W. Robert Lee Brian G. Czito Brian G. Czito |
| author_sort | Corbin D. Jacobs |
| collection | DOAJ |
| description | Purpose: To perform a multi-institutional analysis of patients with synchronous prostate and rectosigmoid cancers.Materials and Methods: A retrospective review of Duke University and Durham Veterans Affairs Medical Center records was performed for men with both prostate and rectosigmoid adenocarcinomas from 1988 to 2017. Synchronous presentation was defined as symptoms, diagnosis, or treatment of both cancers within 12 months of each other. The primary study endpoint was overall survival. Univariate and multivariable Cox regression was performed.Results: Among 31,883 men with prostate cancer, 330 (1%) also had rectosigmoid cancer and 54 (16%) of these were synchronous. Prostate cancer was more commonly the initial diagnosis (59%). Fifteen (28%) underwent prostatectomy or radiotherapy before an established diagnosis of rectosigmoid cancer. Stage I, II–III, or IV rectosigmoid cancer was present in 26, 57, and 17% of men, respectively. At a median follow-up of 43 months, there were 18 deaths due rectosigmoid cancer and two deaths due to prostate cancer. Crude late grade ≥3 toxicities include nine (17%) gastrointestinal and six (11%) genitourinary. Two anastomotic leaks following low anterior resection occurred in men who received a neoadjuvant radiotherapy prostate dose of 70.6–76.4 Gy. Rectosigmoid cancer stages II–III (HR 4.3, p = 0.02) and IV (HR 16, p < 0.01) as well as stage IV prostate cancer (HR 31, p < 0.01) were associated with overall survival on multivariable analysis.Conclusions: Synchronous rectosigmoid cancer is a greater contributor to mortality than prostate cancer. Men aged ≥45 with localized prostate cancer should undergo colorectal cancer screening prior to treatment to evaluate for synchronous rectosigmoid cancer. |
| first_indexed | 2024-12-10T14:01:32Z |
| format | Article |
| id | doaj.art-9d65dae54293471f9e96b37e02f2f1bf |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-10T14:01:32Z |
| publishDate | 2020-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-9d65dae54293471f9e96b37e02f2f1bf2022-12-22T01:45:47ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2020-03-011010.3389/fonc.2020.00345483061Multi-Institutional Analysis of Synchronous Prostate and Rectosigmoid CancersCorbin D. Jacobs0Jacob Trotter1Manisha Palta2Manisha Palta3Michael J. Moravan4Michael J. Moravan5Yuan Wu6Christopher G. Willett7W. Robert Lee8W. Robert Lee9Brian G. Czito10Brian G. Czito11Department of Radiation Oncology, Duke University Medical Center, Durham, NC, United StatesDepartment of Radiation Oncology, Duke University Medical Center, Durham, NC, United StatesDepartment of Radiation Oncology, Duke University Medical Center, Durham, NC, United StatesDepartment of Radiation Oncology, Durham Veteran Affairs Medical Center, Durham, NC, United StatesDepartment of Radiation Oncology, Duke University Medical Center, Durham, NC, United StatesDepartment of Radiation Oncology, Durham Veteran Affairs Medical Center, Durham, NC, United StatesDepartment of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, United StatesDepartment of Radiation Oncology, Duke University Medical Center, Durham, NC, United StatesDepartment of Radiation Oncology, Duke University Medical Center, Durham, NC, United StatesDepartment of Radiation Oncology, Durham Veteran Affairs Medical Center, Durham, NC, United StatesDepartment of Radiation Oncology, Duke University Medical Center, Durham, NC, United StatesDepartment of Radiation Oncology, Durham Veteran Affairs Medical Center, Durham, NC, United StatesPurpose: To perform a multi-institutional analysis of patients with synchronous prostate and rectosigmoid cancers.Materials and Methods: A retrospective review of Duke University and Durham Veterans Affairs Medical Center records was performed for men with both prostate and rectosigmoid adenocarcinomas from 1988 to 2017. Synchronous presentation was defined as symptoms, diagnosis, or treatment of both cancers within 12 months of each other. The primary study endpoint was overall survival. Univariate and multivariable Cox regression was performed.Results: Among 31,883 men with prostate cancer, 330 (1%) also had rectosigmoid cancer and 54 (16%) of these were synchronous. Prostate cancer was more commonly the initial diagnosis (59%). Fifteen (28%) underwent prostatectomy or radiotherapy before an established diagnosis of rectosigmoid cancer. Stage I, II–III, or IV rectosigmoid cancer was present in 26, 57, and 17% of men, respectively. At a median follow-up of 43 months, there were 18 deaths due rectosigmoid cancer and two deaths due to prostate cancer. Crude late grade ≥3 toxicities include nine (17%) gastrointestinal and six (11%) genitourinary. Two anastomotic leaks following low anterior resection occurred in men who received a neoadjuvant radiotherapy prostate dose of 70.6–76.4 Gy. Rectosigmoid cancer stages II–III (HR 4.3, p = 0.02) and IV (HR 16, p < 0.01) as well as stage IV prostate cancer (HR 31, p < 0.01) were associated with overall survival on multivariable analysis.Conclusions: Synchronous rectosigmoid cancer is a greater contributor to mortality than prostate cancer. Men aged ≥45 with localized prostate cancer should undergo colorectal cancer screening prior to treatment to evaluate for synchronous rectosigmoid cancer.https://www.frontiersin.org/article/10.3389/fonc.2020.00345/fullsynchronousprostate cancerrectal cancerradiation therapyanastomotic leak |
| spellingShingle | Corbin D. Jacobs Jacob Trotter Manisha Palta Manisha Palta Michael J. Moravan Michael J. Moravan Yuan Wu Christopher G. Willett W. Robert Lee W. Robert Lee Brian G. Czito Brian G. Czito Multi-Institutional Analysis of Synchronous Prostate and Rectosigmoid Cancers Frontiers in Oncology synchronous prostate cancer rectal cancer radiation therapy anastomotic leak |
| title | Multi-Institutional Analysis of Synchronous Prostate and Rectosigmoid Cancers |
| title_full | Multi-Institutional Analysis of Synchronous Prostate and Rectosigmoid Cancers |
| title_fullStr | Multi-Institutional Analysis of Synchronous Prostate and Rectosigmoid Cancers |
| title_full_unstemmed | Multi-Institutional Analysis of Synchronous Prostate and Rectosigmoid Cancers |
| title_short | Multi-Institutional Analysis of Synchronous Prostate and Rectosigmoid Cancers |
| title_sort | multi institutional analysis of synchronous prostate and rectosigmoid cancers |
| topic | synchronous prostate cancer rectal cancer radiation therapy anastomotic leak |
| url | https://www.frontiersin.org/article/10.3389/fonc.2020.00345/full |
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