前列腺癌患者经放射治疗后发生第二原发膀胱癌的风险分析

doi:10.3969/j.issn.1006-5253.2021.02.005

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Abstract Objective To investigate the risk of second primary bladder cancer (SPBC) in prostate cancer patients after radiation therapy and to assess the robustness of the results to unmeasured confounding. Methods Data from the surveillance, epidemiology and end results (SEER) database of prostate cancer patients with a clear pathological diagnosis from 2004 to 2009 were selected. Patients were divided into radiotherapy and non-radiotherapy groups according to whether they received radiotherapy or not. PSM was applied to match the two groups of patients, the risk of SPBC in post-radiation prostate cancer patients was evaluated using a competing risk model, and sensitivity analysis for unobserved confounders was performed to assess the robustness of results.Results Totally 83 064 radical prostatectomy patients were included in this study, of whom 5 141 (88 with SPBC) and 77 923 (753 with SPBC) were categorized into radiotherapy and non-radiotherapy group. Pre and post=matching competing risk models showed that radiotherapy increased the risk of SPBC in patients undergoing radical prostatectomy (pre-matching SHR=1.438, 95% CI=1.133-1.824, P=0.003; post-matching SHR=1.586, 95%CI=1.076-2.215, P=0.007). Sensitivity analysis showed that the association of unmeasured confounding with radiotherapy and SPBC OR=1.65, and SHR=1.84 could make the observed difference in SPBC between radiotherapy and non-radiotherapy patients insignificant. Conclusion The increased risk of SPBC in prostate cancer patients due to radiotherapy should be judged with caution, and a confounding factor with a relatively low association with outcome or treatment may nullify the results.

Key words： prostate cancer second primary bladder cancer propensity score matching unmeasured confounding sensitivity analysis

Received: 16 December 2020

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	Tan Kangming
	Zhou Qin
	Wu Zhenyu.

Cite this article:

Tan Kangming,Zhou Qin,Wu Zhenyu.. Risk analysis of second primary bladder cancer after radiotherapy in patients undergoing radical prostatectomy[J]. journal1, 2021, 28(2): 112-117.

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http://manu58.magtech.com.cn/Jwk_zgyytj/EN/10.3969/j.issn.1006-5253.2021.02.005 OR http://manu58.magtech.com.cn/Jwk_zgyytj/EN/Y2021/V28/I2/112

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