Boorjian Stephen, Cowan Janet E, Konety Badrinath R, DuChane Janeen, Tewari Ashutosh, Carroll Peter R, Kane Christopher J
Department of Urology, New York Presbyterian Hospital-Weill-Cornell Medical Center, New York, New York, USA.
J Urol. 2007 Mar;177(3):883-7; discussion 887-8. doi: 10.1016/j.juro.2006.10.071.
We evaluated a large disease registry to determine the incidence of bladder cancer in patients with prostate cancer and investigate whether the type of treatment for prostate cancer increased the risk of bladder cancer.
We analyzed the CaPSURE disease registry for men diagnosed with prostate cancer plus bladder cancer between 1989 and 2003. Demographics, comorbidities and prostate cancer treatment modalities were compared in patients with and without bladder cancer. A backward stepwise Cox proportional hazards regression model was used to predict bladder cancer onset after treatment for prostate cancer in patients who had bladder cancer 30 days or greater after prostate cancer treatment.
Of 9,780 patients from CaPSURE 143 (1.46%) also had bladder cancer. Patients with bladder cancer and prostate cancer were older (p<0.01) and more likely to be white (p=0.03), and they had lower levels of income (p<0.01) and education (p=0.04) than patients with prostate cancer only. Comorbidities did not differ between patients with and without bladder cancer. Patients treated with radical prostatectomy were approximately half as likely to have posttreatment bladder cancer as patients who underwent radiation therapy (HR 0.51, 95% CI 0.29-0.89). Patients who smoked had an independent increase in the risk of bladder cancer (HR 2.08, 95% CI 1.09-3.97), while smokers treated with radiation therapy were at almost 4-fold risk for bladder cancer (HR 3.65, 95% CI 1.45-9.16).
The incidence of bladder cancer in patients with prostate cancer was 1.5%. Radiation therapy and smoking increased the risk of bladder cancer.
我们评估了一个大型疾病登记数据库，以确定前列腺癌患者中膀胱癌的发病率，并调查前列腺癌的治疗方式是否会增加患膀胱癌的风险。
我们分析了CaPSURE疾病登记数据库中1989年至2003年间被诊断为前列腺癌合并膀胱癌的男性患者的数据。对患有和未患有膀胱癌的患者的人口统计学、合并症和前列腺癌治疗方式进行了比较。采用向后逐步Cox比例风险回归模型预测前列腺癌治疗后30天或更长时间发生膀胱癌的患者在前列腺癌治疗后膀胱癌的发病情况。
在CaPSURE的9780名患者中，143名（1.46%）也患有膀胱癌。患有膀胱癌和前列腺癌的患者年龄更大（p<0.01），更有可能是白人（p=0.03），与仅患有前列腺癌的患者相比，他们的收入水平（p<0.01）和教育程度（p=0.04）较低。患有和未患有膀胱癌的患者合并症无差异。接受根治性前列腺切除术的患者治疗后发生膀胱癌的可能性约为接受放射治疗患者的一半（风险比0.51，95%置信区间0.29-0.89）。吸烟患者患膀胱癌的风险独立增加（风险比2.08，95%置信区间1.09-3.97），而接受放射治疗的吸烟患者患膀胱癌的风险几乎是4倍（风险比3.65，95%置信区间1.45-9.16）。
前列腺癌患者中膀胱癌的发病率为1.5%。放射治疗和吸烟会增加患膀胱癌的风险。
