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Second Primaries for Over 25% With Metastatic Prostate Cancer

28.1 percent have synchronous second primary; mortality up with synchronous lung, stomach cancer

THURSDAY, April 23, 2015 (HealthDay News) -- More than one-quarter of patients with metastatic prostate cancer present with a synchronous second primary malignancy, according to a review published in the April issue of The Journal of Urology.

Kyo Chul Koo, M.D., Ph.D., from the Yonsei University College of Medicine in Seoul, South Korea, and colleagues conducted a retrospective record review of 582 consecutive patents with prostate cancer diagnosed with metastasis. The authors examined the prognostic impact of a synchronous second primary malignancy, defined as a cytologically or histologically proven solid malignancy, on overall survival.

The researchers found that 28.1 percent of patients had a synchronous second primary malignancy, of which the most prevalent types were colorectal (9.1 percent), stomach (7.3 percent), and lung (7.1 percent) cancers. During a median follow-up of 34.1 months, the rate of overall survival was significantly higher for patients without a synchronous secondary primary malignancy versus those with lung or stomach cancer. Outcomes were comparable for men without a second malignancy and for those with colorectal cancer. Independent predictors of overall mortality included clinical stage T4 or greater, American Society of Anesthesiologists score 1 or greater, and lung or stomach cancer.

"A substantial proportion of patients with metastatic prostate cancer present with a synchronous second primary malignancy," the authors write. "Definitive therapy targeting prostate cancer may confer a limited survival benefit in patients with synchronous lung or stomach cancer."

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