Yamamoto Manabu, Matsuyama Ayumi, Kameyama Toshifumi, Okamoto Masahiro, Okazaki Jin, Utsunomiya Tohru, Tsutsui Shinichi, Ishida Teruyoshi
Department of Surgery, Hiroshima Atomic Bomb Survivors Hospital, Hiroshima, Japan.
J Surg Oncol. 2009 Dec 1;100(7):594-7. doi: 10.1002/jso.21399.
During the decade following the 1945 atomic bombing of Hiroshima, a high incidence of leukemia was observed among atomic bomb survivors. Subsequently, the incidence of other cancers gradually increased while that of leukemia decreased. We examined the long-term clinical outcome of gastric cancer and second primary cancer in atomic bomb survivors.
Results of surgical treatment of gastric cancer were reviewed in 231 atomic bomb survivors and 759 control patients between 1995 and 2006.
Long-term prognosis of gastric cancer in atomic bomb survivors was significantly poorer than that in control patients (P < 0.05). In a multivariate analysis, age, depth of tumor invasion, lymph node metastases, and curability were found to be significant and independent prognostic factors for gastric cancer. The incidence of second primary cancer after gastric cancer was significantly higher in survivors than in control patients (P < 0.01), because the number of elderly patients in the survivors was higher.
Gastric cancer in survivors had a significantly poorer prognosis. Although the frequency of second primary cancer after gastric cancer in survivors was higher than that in control patients, it did not influence the prognosis.
在1945年广岛原子弹爆炸后的十年间，观察到原子弹幸存者中白血病发病率很高。随后，其他癌症的发病率逐渐上升，而白血病的发病率则下降。我们研究了原子弹幸存者中胃癌和第二原发性癌症的长期临床结局。
回顾了1995年至2006年间231名原子弹幸存者和759名对照患者的胃癌手术治疗结果。
原子弹幸存者中胃癌的长期预后明显比对照患者差（P < 0.05）。在多变量分析中，年龄、肿瘤浸润深度、淋巴结转移和可治愈性被发现是胃癌重要且独立的预后因素。胃癌后第二原发性癌症的发病率在幸存者中明显高于对照患者（P < 0.01），因为幸存者中老年患者的数量较多。
幸存者中的胃癌预后明显较差。尽管幸存者中胃癌后第二原发性癌症的发生率高于对照患者，但它并未影响预后。
