[Interdisciplinary oncologic after-care exemplified by second primary tumors after bladder carcinoma]

The primary intention of oncological follow-up for patients with bladder cancer is the early diagnosis of recurrent local tumors or metastatic disease. The question of subsequent independent tumors has not been assessed as very important. Data from the central cancer registry of Regensburg/Germany for the period 1990-1997 were examined to determine the risk of second primary cancers following an initial bladder cancer. Records of 921 males (mean age: 65.4 years) and 339 females (mean age: 68.0 years) with the primary diagnosis of bladder cancer were analyzed. The minimal follow-up has been 5 years. Bladder cancer patients experience an excess risk of subsequent independent malignancies. The ratio of observed cases to expected cases of subsequent tumors was increased. During the follow-up period, subsequent tumors have been found in 153 (16.6%) male patients and 35 (10.3%) female patients. The most common subsequent malignancies in males were prostate cancer (71 cases) and bronchial cancer (19 cases). Breast cancer (nine cases) and colon cancer were predominant in females. This confirms the good sense of regular oncological follow-up. In this context attention should be directed at tumors of non urological origin, and an interdisciplinary approach with an individual oncological follow-up seems to be useful. The focus should be on the prostate and lung for males and the breast and colon for females.