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. 2020 Feb 21;15(2):e0227552.
doi: 10.1371/journal.pone.0227552. eCollection 2020.

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

Juha Mehtälä  1 , Jihong Zong  2 , Zdravko Vassilev  2 , Gunnar Brobert  3 , Montse Soriano Gabarró  4 , Pär Stattin  5 , Houssem Khanfir  1
Affiliations

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

Juha Mehtälä et al. PLoS One. .

Abstract

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.

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Conflict of interest statement

I have read the journal’s policy and the authors of this manuscript have the following competing interests: This study was supported by Bayer AG. ZV, JZ, GB and MSG are employed by Bayer. JM and HK are employees of EPID Research, a contract research organization that performs commissioned pharmacoepidemiologic studies in collaboration with several pharmaceutical companies. PS has no conflict of interests reported. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Kaplan-Meier survival curves among prostate cancer patients with bone metastases (mPC), and among castration-resistant prostate cancer patients with bone metastases (mCRPC).
See this image and copyright information in PMC

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