Multiple primary neoplasms in association with prostate cancer in black and white patients.

The current study follows up the 983 patients who were diagnosed as having prostate cancer at the Columbia-Presbyterian Medical Center in New York City between 1970 and 1979 and of whom 106 (11.5%) developed a multiple primary malignant neoplasm (MPMN) in addition to their prostate cancer by January 1, 1986. Of the 283 black patients, 32 (11.3%) developed an MPMN involving 35 sites excluding prostate. Of the 636 white patients, 74 (11.6%) developed an MPMN in association with their prostate cancer. Comparing observed incidence rates to expected on the basis of SEER incidence data, two malignant tumors, urinary bladder cancer and malignant lymphoma, appeared to occur in excess in the present series of patients. The excess of urinary bladder cancer in our series could be explained by detection bias due to the routine use of cystoscopy. The excess incidence of lymphoma in our series appears significant but its etiology is unexplained.

Multiple primary tumors in association with prostatic cancer.

One hundred forty-six patients with clinically nonmetastatic carcinoma of the prostate were treated at Columbia-Presbyterian Medical Center from 1964 through 1976. Of these 146 patients, 24 (16.4%) had developed at least one additional primary cancer. This review contrasts the 122 patients who had a single primary prostate cancer only with the 24 patients who had additional primary carcinomas with respect to age, racial distribution, clinical stage, and prostate cancer histology including Gleason's score, patterns of failure of prostate cancer, and survival data. Local failure and distant failure were less in the multiple primary group. Patients with high Gleason's scores appear to be at greater risk for second primaries. Five-year observed survival (by actuarial life table method) for the single prostate primary group was 76.5%, and 5-year observed survival of the prostate multiple primary group where prostate cancer appeared first was 71%.

Uterine sarcomas: a clinicopathologic study, 1965-1981.

Forty-six cases diagnosed as uterine sarcoma from 1965 to 1981 were analyzed. Using mitotic count, 7 of 21 leiomyosarcomas (LMS) were redesignated leiomyomas and all are NED. The actuarial survival rates for the 38 considered sarcomas were 55 and 27% at 2 and 5 years. (The 22 patients eligible for 5-year follow-up had a 27% absolute survival, with 3 of 22 NED.) Fourteen LMS patients had a superior 5-year actuarial survival (42%) than 18 malignant mixed mesodermal (MMM) patients (15%), but the difference disappears when only patients under 70 are considered. Stage and age were the most important prognostic indicators. Complete surgical resection was essential for long-term survival. Six resected patients given adjuvant chemotherapy (mostly VAC) had an improved actuarial survival (61 vs 15% for the 23 resected patients not receiving chemotherapy). Seventy percent of 23 recurrences occurred within 2 years and average survival post-recurrence was 7.6 months. Survival post-recurrence for 8 patients was not improved by chemotherapy. Seventy-eight percent of recurrences had a distal component, with lung being the most common site.