Background: As AUA guideline for the Management of Clinically Localized Prostate Cancer: 2007 Update states “An assessment of the patient's life expectancy, overall health status, and tumor characteristics should be undertaken before any treatment decisions can be made," definitive therapy for localized prostate cancer is usually recommended for patients with 5-year life expectancy or more. In some cases, however, unexpected lethal disease is diagnosed and causes death within 5 years after prostate cancer treatment. It seems important to elucidate the characteristics of other causes of death during follow up period after definitive therapy for localized prostate cancer (PCa). Patients and Methods: We reviewed 664 consecutive patients who had received radical prostatectomy (RP, n = 107) or external beam radiotherapy (EBRT, n = 557) and been followed up over 5 years at our institute. Survival status was evaluated and cause of death was identified in dead cases. All cases underwent chest and abdominal computed tomography (CT) and bone scan that were negative for metastasis. Results: At latest follow up, 103 (15.5%) patients were dead of PCa (n = 48) and other causes (n = 55), respectively. Of the 55 patients who died of other causes, 26 did not survive 5 years after radical treatment for PCa. 54% of them died of other malignancies including lung (n = 7) and gastrointestinal (GI) tract (n = 3), lymphoma (n = 2), liver (n = 1), and pancreatic (n = 1) cancers. Non-cancer causes included cerebrovascular disease (n = 3), pulmonary disease (n = 3), ischemic heart disease (n = 2), and unknown (n = 3). Conclusions: Since all patients had negative chest CT for primary lung cancer, some patients with localized PCa seemed to have developed more lethal and rapid malignancy after treatment for PCa. Urologists may need to pay their attention that their patients undergo regular mass screening for common diseases even if they were under urological follow up. Pretreatment test for fecal occult blood may be useful to screen GI tract cancer before treatment initiation.
Citation Format: Takashi Kobayashi, Tomomi Kamba, Naoki Terada, Toshinari Yamasaki, Itaru Ikeda, Haruo Inokuchi, Yoshiki Norihisa, Takashi Mizowaki, Takahiro Inoue, Kazutoshi Okubo, Koji Yoshimura, Masahiro Hiraoka, Osamu Ogawa. Non-prostate cancer death within 5 years after radical therapy in men with localized prostate cancer. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 4677. doi:10.1158/1538-7445.AM2013-4677