Prostate Cancer History Does Not Increase the Risk of Rectal Cancer Recurrence, suggests study

A recent study published in the International Journal of Colorectal Disease addressed a key query in cancer treatment whether men with a history of prostate cancer (PC) face worse outcomes after rectal cancer surgery. The study analyzed data from both the Swedish Colorectal Cancer Registry and the National Prostate Cancer Registry and concluded that previous prostate cancer diagnosis did not significantly impact rectal cancer recurrence or overall mortality in men undergoing bowel resection.

Limited data existed on how a prior prostate cancer diagnosis influences the outcomes following rectal cancer surgery. This study wanted to fill that gap by investigating whether men with a history of PC, who later developed rectal cancer, had higher overall mortality or a greater risk of rectal cancer recurrence. The study identified a total of 13,299 men who underwent rectal cancer surgery between 2000 and 2016. Of these, 1,130 had previously been diagnosed with PC. Cox regression analysis with propensity score matching was employed to compare outcomes after adjusting for confounding factors. The primary focus was overall mortality, while the secondary outcome measured the recurrence of rectal cancer.

The study found no significant difference in overall mortality between men with and without a previous PC diagnosis. However, further analysis revealed that men with lower or intermediate-risk prostate cancer had a reduced overall mortality risk after rectal cancer surgery when compared to the patients without a PC diagnosis. Also, men with low- or intermediate-risk PC had a 21% lower overall mortality (hazard ratio [HR] 0.79, 95% confidence interval [CI] 0.70–0.90), while the individuals with high-risk PC had a 15% lower mortality (HR 0.85, 95% CI 0.74–0.98).

There was no statistically significant difference in rectal cancer recurrence between men with a history of PC, regardless of risk level, and the individuals without prior prostate cancer. For men with low- or intermediate-risk PC, the recurrence risk was only slightly lower (HR 0.92, 95% CI 0.74–1.14), while men with high-risk PC had a marginally lower recurrence rate, despite not being significant (HR 0.73, 95% CI 0.52–1.01).

The study offers reassuring news for men with a history of prostate cancer who face rectal cancer surgery. Overall mortality rates were slightly lower for the individuals with prior PC, and no substantial difference was observed in cancer recurrence rates. These findings suggest that a history of prostate cancer does not negatively affect outcomes for rectal cancer patients, and in some cases, survival rates may be better.

Source:

Sverrisson, I., Smedh, K., Chabok, A., & Nikberg, M. (2024). The risk for rectal cancer recurrence and overall mortality is not increased in men previously diagnosed with prostate cancer: a report from the Swedish colorectal cancer registry. In International Journal of Colorectal Disease (Vol. 39, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1007/s00384-024-04710-y