Prostate cancer treatment with radiation is associated with a greater risk for bladder cancer compared with surgery, investigators concluded in a presentation at the Society of Urologic Oncology’s 23rd annual meeting in San Diego, California.

In a study of 2000 to 2019 data from 418,053 patients in the Surveillance, Epidemiology, and End Results (SEER) database, Steven Monda, MD, from UC Davis Health in Sacramento, California, and colleagues found that brachytherapy and external beam radiation therapy (EBRT) were significantly associated with an approximately 2.4-and 2.5-fold increased risk for bladder cancer, respectively, compared with radical prostatectomy (RP), in adjusted analyses. RP followed by EBRT was significantly associated with a 1.5-fold increased risk for bladder cancer compared with RP alone.

In addition, results showed that bladder cancer diagnosed after radiation compared with after RP was not significantly more likely to be muscle invasive (16.6% vs 14.6%) or to be high grade (36.5% vs 36.7%). Variant histology (micropapillary or sarcomatoid) bladder cancer was significantly more likely after radiation compared with RP (0.7% vs 0.3%).

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Monda S, Pratsinis M, Noel O, Lui H, Evans C, Dall’Era M. Bladder cancer after prostate cancer treatment: A SEER competing risk comparison between prostatectomy and radiation. Presented at: SUO 2022, November 30 to December 2, San Diego, California. Poster 55.