Long-Term Second Malignancies in Prostate Cancer Patients Treated With Low-Dose-Rate Brachytherapy and Radical Prostatectomy

No AccessJournal of UrologyAdult Urology11 Apr 2024Long Term Second Malignancies in Prostate Cancer Patients Treated with Low-Dose-Rate Brachytherapy and Radical Prostatectomy Marie-Pier St-Laurent, George Acland, Sarah N. Hamilton, Jeremy Hamm, Katherine Sunderland, Peter C. Black, Michael McKenzie, Mira Keyes, Stacy Miller, Martin E. Gleave, and Scott Tyldesley Marie-Pier St-LaurentMarie-Pier St-Laurent https://orcid.org/0000-0002-7823-4857 , George AclandGeorge Acland , Sarah N. HamiltonSarah N. Hamilton , Jeremy HammJeremy Hamm , Katherine SunderlandKatherine Sunderland , Peter C. BlackPeter C. Black , Michael McKenzieMichael McKenzie , Mira KeyesMira Keyes , Stacy MillerStacy Miller , Martin E. GleaveMartin E. Gleave , and Scott TyldesleyScott Tyldesley Corresponding Author: Scott Tyldesley, Department of Radiation Oncology, British Columbia Cancer Agency ( (email protected) ). View All Author Informationhttps://doi.org/10.1097/JU.0000000000003965AboutPDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareFacebookLinked InTwitterEmail Abstract Purpose: Second malignancy is a rare but potentially lethal event after prostate brachytherapy, but data remain scarce on its long-term risk. The objective of this study is to estimate the number of pelvic second malignancies following brachytherapy compared to prostatectomy (RP). Materials and Methods: Retrospective review of patients treated with low dose 125I brachytherapy and prostatectomy in British Columbia from 1999 to 2010. Kaplan Meier (KM) estimates for pelvic (bladder and rectum), invasive pelvic, any second malignancy and death from any second malignancy were assessed. Cox multivariable analyses were performed adjusting for initial treatment type, age, post RP adjuvant/salvage EBRT status, and smoking history. Results: Two thousand three hndred seventy-eight brachytherapy and 9089 prostatectomy patients were included. Median age was 66 years (IQR 61-71) and 63 years (IQR 58-67), respectively. Median follow-up time to event or censured was 14 years (IQR 11.5-17.3). The KM estimates for pelvic second malignancy at 15 and 20 years were 6.4% and 9.8% after brachytherapy, and 3.2% and 4.2% after prostatectomy. Time to any second malignancy and time to death from any second malignancy were not significantly different (P > .05). On Cox-multivariable analysis, brachytherapy, compared to surgery, was an independent factor for pelvic (HR 1.81 95% CI 1.45-2.26, P < .001) and invasive pelvic second malignancy (HR 2.13 95% CI 1.61-2.83, P < .001). Increased age and smoking were also associated with higher estimates of events (P < .001). Conclusion: After adjustment for age, post RP adjuvant/salvage EBRT status and smoking status, numerically higher long-term HRs of pelvic and invasive pelvic second malignancy in patients treated with brachytherapy compared to radical prostatectomy were noted. © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Supplementary Materials Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Keywordsprostatic neoplasmsneoplasmsradiation-inducedbrachytherapyradiotherapyprostatectomyMetrics Author Information Marie-Pier St-Laurent More articles by this author George Acland More articles by this author Sarah N. Hamilton More articles by this author Jeremy Hamm More articles by this author Katherine Sunderland More articles by this author Peter C. Black More articles by this author Michael McKenzie More articles by this author Mira Keyes More articles by this author Stacy Miller More articles by this author Martin E. Gleave More articles by this author Scott Tyldesley Corresponding Author: Scott Tyldesley, Department of Radiation Oncology, British Columbia Cancer Agency ( (email protected) ). More articles by this author Expand All Advertisement PDF downloadLoading ...