Risk and prognosis of secondary bladder cancer after post-operative radiotherapy for gynecological cancer


  • Li Wen Department of Prenatal Diagnosis and Screening Center, Hangzhou Women’s Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, Zhejiang, China
  • Guansheng Zhong Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
  • Yingjiao Zhang Department of Gastroenterology, The 903 Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army, Hangzhou, Zhejiang, China
  • Miaochun Zhong Department of General Surgery, Zhejiang Provincial People's Hospital, Affiliated People’s hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China




Gynecological cancer, secondary bladder cancer, radiation therapy, prognosis, SEER


The aim of this study was to investigate the impacts of radiation therapy (RT) on the occurrence risk of secondary bladder cancer (SBC) and on the patients’ survival outcome after being diagnosed with gynecological cancer (EC). The data was obtained from the SEER database between 1973 and 2015. Chi-squared test was used to compare the clinicopathological characteristics among the different groups. Fine and Gray’s competing risk model was used to assess the cumulative incidence and occurrence risk of SBC in GC survivors. Kaplan-Meier method was utilized for survival analysis. A total of 123,476 GC patients were included, among which 31,847 (25.8%) patients received RT while 91629 (74.2%) patients did not. The cumulative incidence of SBC was 1.59% or 0.73% among patients who had received prior GC specific RT or not, respectively. All EBRT (standardized incidence ratio (SIR) =2.49, 95% CI [2.17-2.86]), brachytherapy (SIR =1.96, 95% CI [1.60-2.38]), and combinational RT modality groups (SIR =2.73, 95% CI [2.24-3.28]) had dramatically higher SBC incidence as compared to the US general population. Receiving EBRT (HR = 2.83, 95% CI [2.34–3.43]), brachytherapy (HR = 2.17, 95% CI [1.67–2.82]), and combinational RT modality (HR = 2.97, 95% CI [2.34–3.77]) were independent risk factors for SBC development. Survival detriment was observed in SBC patients who received RT after GC diagnosis, as compared to those who did not receive RT. In conclusion, patients who underwent RT after GC had an increased risk of developing bladder as a secondary primary cancer. A long-term surveillance for SBC occurrence is necessary for GC patients who have received prior RT.



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Translational and Clinical Research


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Risk and prognosis of secondary bladder cancer after post-operative radiotherapy for gynecological cancer. Biomol Biomed [Internet]. 2022 Jun. 1 [cited 2024 Jul. 19];22(3):471-80. Available from: https://bjbms.org/ojs/index.php/bjbms/article/view/6338