Bladder and rectal cancer development in prostate cancer patients treated with surgery or radiotherapy: A...

Radical prostatectomy (RP) and radiotherapy (RT) are the main treatment options for localized and locally advanced (LA) prostate cancer (PCa). While erectile dysfunction and urinary incontinence have been widely studied, there is limited evidence regarding pelvic malignancies and radiation-induced rectal or urinary toxicity.

This retrospective study involved patients with localized and LA PCa treated exclusively with RP or RT between 2010 and 2019 in our Health Department. A total of 356 patients were included: 138 treated with RP and 218 with RT. Rectal and bladder tumors, as well as urinary and gastrointestinal toxicity variables, were compared using the chi-square test (Fisher's exact test when expected frequencies were <5). Multivariate analysis was performed using logistic regression adjusted for clinical variables. Statistical significance was set at P < .05.

Both groups were homogeneous in terms of tumor stage and smoking status. Statistically significant differences were observed between groups in the incidence of pelvic tumors [P = .032], bladder tumors [P = .033], and urinary and gastrointestinal toxicity [P < .001]. Patients treated with radiotherapy had an almost 11-fold increased risk of bladder tumors (OR: 10.61; CI: 1.42-224.98).

In our series, patients with localized and LA PCa treated with RT presented a higher incidence of pelvic tumors and urinary/rectal toxicity compared with those treated with RP.