Overall survival and second primary malignancies in men with metastatic prostate cancer.

BACKGROUND:Among prostate cancer (PC) patients, over 90% of distant metastases occur in the bone. PC treatments may be associated with side effects, including second primary malignancies (SPM). There is limited information on the incidence of SPM among men with bone metastatic PC (mPC) and among men...

Full description

Bibliographic Details
Main Authors: Juha Mehtälä, Jihong Zong, Zdravko Vassilev, Gunnar Brobert, Montse Soriano Gabarró, Pär Stattin, Houssem Khanfir
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2020-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0227552
_version_ 1818403353437143040
author Juha Mehtälä
Jihong Zong
Zdravko Vassilev
Gunnar Brobert
Montse Soriano Gabarró
Pär Stattin
Houssem Khanfir
author_facet Juha Mehtälä
Jihong Zong
Zdravko Vassilev
Gunnar Brobert
Montse Soriano Gabarró
Pär Stattin
Houssem Khanfir
author_sort Juha Mehtälä
collection DOAJ
description BACKGROUND:Among prostate cancer (PC) patients, over 90% of distant metastases occur in the bone. PC treatments may be associated with side effects, including second primary malignancies (SPM). There is limited information on the incidence of SPM among men with bone metastatic PC (mPC) and among men with bone metastatic castration-resistant PC (mCRPC). We estimated overall survival and the incidence of SPM in men with mPC and mCRPC. METHODS:In the Prostate Cancer data Base Sweden, the National Prostate Cancer Register was linked to other national health care registers, 15,953 men with mPC in 1999-2011 were identified. Further, 693 men with mCRPC were identified. Outcomes were evaluated using stratified incidence rates, Kaplan-Meier estimators and Cox models. RESULTS:The mean age among men with mPC was 73.9 years and in men with mCRPC 70.0 years. The median respective survivals were 1.5 (13,965 deaths) and 1.14 years (599 deaths), and average times since PC diagnosis 1.8 and 4.7 years. We observed 2,669 SPMs in men with mPC and 100 SPMs in men with mCRPC. The incidence rate of SPM per 1,000 person-years was 81.8 (78.8-85.0) for mPC and 115.6 (95.1-140.7) for mCRPC. High age, prior neoplasms, urinary tract infection, congestive heart failure, diabetes and renal disease were most strongly associated with increased mortality risk. Prior neoplasms and prior use of antineoplastic agents were most strongly associated with increased SPM risk. Several factors associated with increased mortality and SPM risks were more prevalent in the mCRPC cohort. CONCLUSIONS:Our results on mortality for men with mPC and mCRPC are in line with previous studies from the same time period. Investigation of factors associated with mortality and SPM in men with mPC and mCRPC can help to further understand these outcomes in the era prior to several new treatments have come available.
first_indexed 2024-12-14T08:22:55Z
format Article
id doaj.art-e83d93f64e39495a97f8ca7bcecd8cbd
institution Directory Open Access Journal
issn 1932-6203
language English
last_indexed 2024-12-14T08:22:55Z
publishDate 2020-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj.art-e83d93f64e39495a97f8ca7bcecd8cbd2022-12-21T23:09:44ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01152e022755210.1371/journal.pone.0227552Overall survival and second primary malignancies in men with metastatic prostate cancer.Juha MehtäläJihong ZongZdravko VassilevGunnar BrobertMontse Soriano GabarróPär StattinHoussem KhanfirBACKGROUND:Among prostate cancer (PC) patients, over 90% of distant metastases occur in the bone. PC treatments may be associated with side effects, including second primary malignancies (SPM). There is limited information on the incidence of SPM among men with bone metastatic PC (mPC) and among men with bone metastatic castration-resistant PC (mCRPC). We estimated overall survival and the incidence of SPM in men with mPC and mCRPC. METHODS:In the Prostate Cancer data Base Sweden, the National Prostate Cancer Register was linked to other national health care registers, 15,953 men with mPC in 1999-2011 were identified. Further, 693 men with mCRPC were identified. Outcomes were evaluated using stratified incidence rates, Kaplan-Meier estimators and Cox models. RESULTS:The mean age among men with mPC was 73.9 years and in men with mCRPC 70.0 years. The median respective survivals were 1.5 (13,965 deaths) and 1.14 years (599 deaths), and average times since PC diagnosis 1.8 and 4.7 years. We observed 2,669 SPMs in men with mPC and 100 SPMs in men with mCRPC. The incidence rate of SPM per 1,000 person-years was 81.8 (78.8-85.0) for mPC and 115.6 (95.1-140.7) for mCRPC. High age, prior neoplasms, urinary tract infection, congestive heart failure, diabetes and renal disease were most strongly associated with increased mortality risk. Prior neoplasms and prior use of antineoplastic agents were most strongly associated with increased SPM risk. Several factors associated with increased mortality and SPM risks were more prevalent in the mCRPC cohort. CONCLUSIONS:Our results on mortality for men with mPC and mCRPC are in line with previous studies from the same time period. Investigation of factors associated with mortality and SPM in men with mPC and mCRPC can help to further understand these outcomes in the era prior to several new treatments have come available.https://doi.org/10.1371/journal.pone.0227552
spellingShingle Juha Mehtälä
Jihong Zong
Zdravko Vassilev
Gunnar Brobert
Montse Soriano Gabarró
Pär Stattin
Houssem Khanfir
Overall survival and second primary malignancies in men with metastatic prostate cancer.
PLoS ONE
title Overall survival and second primary malignancies in men with metastatic prostate cancer.
title_full Overall survival and second primary malignancies in men with metastatic prostate cancer.
title_fullStr Overall survival and second primary malignancies in men with metastatic prostate cancer.
title_full_unstemmed Overall survival and second primary malignancies in men with metastatic prostate cancer.
title_short Overall survival and second primary malignancies in men with metastatic prostate cancer.
title_sort overall survival and second primary malignancies in men with metastatic prostate cancer
url https://doi.org/10.1371/journal.pone.0227552
work_keys_str_mv AT juhamehtala overallsurvivalandsecondprimarymalignanciesinmenwithmetastaticprostatecancer
AT jihongzong overallsurvivalandsecondprimarymalignanciesinmenwithmetastaticprostatecancer
AT zdravkovassilev overallsurvivalandsecondprimarymalignanciesinmenwithmetastaticprostatecancer
AT gunnarbrobert overallsurvivalandsecondprimarymalignanciesinmenwithmetastaticprostatecancer
AT montsesorianogabarro overallsurvivalandsecondprimarymalignanciesinmenwithmetastaticprostatecancer
AT parstattin overallsurvivalandsecondprimarymalignanciesinmenwithmetastaticprostatecancer
AT houssemkhanfir overallsurvivalandsecondprimarymalignanciesinmenwithmetastaticprostatecancer