[Second neoplasm after treatment of localized prostate cancer]

Prostate cancer (PC) treatment in early stages is radical prostatectomy (RP) or external radiotherapy (ER). There is some uncertainty regarding the development of new ER induced malignant tumors or second primary tumor (SPT), a fact influencing the choice of therapy. The purpose of this study is to determine the best therapeutic alternative for localized PC, in regards to incidence and time of development of.

A systematic review of the literature is proposed by means of evaluation of studies conducted with localized PC and treated with RP or ER, published between 1990 and 2010. The Mega searchers used were Cochrane Library and Trip Database, and the data bases used were MEDLINE, OVID, Science Direct, SciELO and LiLACS, using MeSH terms and free words. The studies selected were analyzed using the MINCIR score of methodological quality (MQ) to compare articles with different design. The variables were considered to be number of patients treated, localization of lesions, global incidence of STP and MQ of the studies. Averages, medians and weighted averages (WA) were calculated. The study groups were compared using the 95% confidence intervals of the medians.

Eleven articles fulfilled the screening criteria (retrospective cohorts and case series); providing 13 series for the study. The average of MQ was 14.7 points (13 and 16 points). The most frequent localizations of STP were bladder, rectum and long. The WA of the global incidence of STP for the series was 3.6% (4.1% for ER and 2.2% RP) CONCLUSION: The information existing did not make it possible to demonstrated an association between the appearance of STP and therapies for localized PC, it even though there was a superior tendency in irradiated patients.