既往睾丸癌后侵袭性前列腺癌发病率增加的分析

IF 2.4 3区医学 Q3 ONCOLOGY

Urologic Oncology-seminars and Original Investigations Pub Date : 2025-03-01 DOI:10.1016/j.urolonc.2024.12.101

Kevin Joseph Xu, Amir Khan, Minhaj Siddiqui

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引用次数: 0

摘要

最近的一些研究表明，与一般人群相比，睾丸癌幸存者患侵袭性前列腺癌的风险增加，而其他研究则没有发现这种联系。本研究的目的是确定睾丸癌幸存者在以后的生活中是否有更高的侵袭性前列腺癌发病率和更高的前列腺癌特异性死亡率风险。方法：这是一项回顾性病例对照研究，研究对象是罹患前列腺癌的患者，以及之前患有睾丸癌或对照组癌症超过5年的患者。我们使用监测、流行病学和最终结果（SEER）数据库访问1975-2020年的全国癌症患者数据，并确定与对照组相比，有睾丸癌病史的患者是否更早发展为更具侵袭性的继发性前列腺癌，且死亡率更高。由于睾丸癌的5年相对生存率较高，对照组包括乳腺癌、膀胱癌、脑神经和神经系统癌（不含脑癌）、眼/眶癌、口腔癌、皮肤癌、肾癌、甲状腺癌。采用Gleason评分、PSA、肿瘤分期和生存时间对患者的发病率和死亡率进行评估，并相应地将其分为低、中、高风险。采用Cox回归模型确定死亡风险。结果：我们发现，与对照组相比，前列腺癌在全球范围内确实更多地发生在睾丸癌患者中。睾丸癌组诊断前列腺癌的平均年龄为61.62 +/- 7.88岁，对照组为66.66 +/- 8.8岁。到60岁时，我们发现睾丸癌组10.7%的患者发展为前列腺癌，而对照组为6.8%。睾丸癌组患者的生存时间（105个月）比对照组（136个月）缩短。结论：与其他癌症幸存者相比，有睾丸癌病史的患者早期发展为前列腺癌的风险更高，死亡率更高。有必要进行确证性研究。

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ANALYSIS OF THE INCREASED INCIDENCE OF AGGRESSIVE PROSTATE CANCER AFTER PRIOR TESTICULAR CANCER

Introduction

Some recent studies have suggested that testicular cancer survivors are at increased risk of developing aggressive prostate cancer compared to the general population while others have not found this link. The objective of this study is to determine if testicular cancer survivors are predisposed to higher incidence of aggressive prostate cancer later in life and greater risks of prostate cancer specific mortality.

Methods

This was a retrospective case-control study of patients who developed prostate cancer and who previously had either testicular cancer or a control group cancer greater than five years prior. We used the Surveillance, Epidemiology, and End Results (SEER) database to access national cancer patient data from 1975-2020 and identify if patients with a history of testicular cancer have an earlier development of more aggressive secondary prostate cancer with higher mortality compared to those in the control group. Due to the high 5-year relative survival of testicular cancer, the control group included breast, bladder, cranial nerves and nervous system (excluding the brain), eye/orbital, oral cavity, skin, renal, thyroid cancers. Patient morbidity and mortality was assessed using Gleason scores, PSA, tumor stage, and survival time and stratified into low, moderate, and high risk accordingly. Cox regression models were used to determine the risk of mortality.

Results

We identified that prostate cancer does occur globally more in patients with testicular cancer compared to controls. The mean age in years of prostate cancer diagnosis for the testicular cancer group was 61.62 +/- 7.88, while the control group was 66.66 +/- 8.8. By the age of 60, we found that 10.7% of patients in the testicular cancer group had developed prostate cancer, compared to 6.8% of the control group. Patients in the testicular cancer group saw a decreased survival time in months (105) compared to the control (136).

Conclusions

We determined that patients with a history of testicular cancer may be at an increased risk of developing prostate cancer earlier with a higher mortality rate compared to other cancer survivors. Confirmatory studies are warranted.

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来源期刊

Urologic Oncology-seminars and Original Investigations 医学-泌尿学与肾脏学

CiteScore

4.80

自引率

3.70%

发文量

297

审稿时长

7.6 weeks

期刊介绍： Urologic Oncology: Seminars and Original Investigations is the official journal of the Society of Urologic Oncology. The journal publishes practical, timely, and relevant clinical and basic science research articles which address any aspect of urologic oncology. Each issue comprises original research, news and topics, survey articles providing short commentaries on other important articles in the urologic oncology literature, and reviews including an in-depth Seminar examining a specific clinical dilemma. The journal periodically publishes supplement issues devoted to areas of current interest to the urologic oncology community. Articles published are of interest to researchers and the clinicians involved in the practice of urologic oncology including urologists, oncologists, and radiologists.