Shoji Koichi, Teishima Jun, Hayashi Tetsutaro, Shinmei Shunsuke, Akita Tomoyuki, Sentani Kazuhiro, Takeshima Yukio, Arihiro Koji, Tanaka Junko, Yasui Wataru, Matsubara Akio
Department of Urology, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima 734-8551, Japan.
Department of Epidemiology, Infectious Disease Control and Prevention, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima 734-8551, Japan.
Oncol Lett. 2017 Jul;14(1):299-305. doi: 10.3892/ol.2017.6119. Epub 2017 May 4.
An atomic bomb (A-bomb) was dropped on Hiroshima on 6th August 1945. Although numerous studies have investigated cancer incidence and mortality among A-bomb survivors, only a small number have addressed urological cancer in these survivors. The aim of the present study was to investigate the clinicopathological features of prostate cancer (PCa) in A-bomb survivors. The clinicopathological features and prognosis of PCa were retrospectively reviewed in 212 survivors and 595 control patients between November 1996 and December 2010. The histopathological and clinical outcomes of surgical treatment of PCa were also evaluated in 69 survivors and 162 control patients. Despite the higher age at diagnosis compared with the control group (P=0.0031), survivors were more likely to have been diagnosed with PCa from a health check compared with the control group (P<0.0001). As a consequence, the survivors were found to exhibit metastasis significantly less frequently (199/212, 93.9%) compared with the control patients (521/595, 87.6%; P=0.0076). Prognosis in the two groups was examined, subsequent to a mean length of follow-up of 44 months. Overall survival (OS) and PCa-specific survival (CS) were similar between the two groups (OS, P=0.2196; CS, P=0.1017). A-bomb exposure was not found to be an independent predictor for prognosis by multivariate analysis (OS, P=0.7800; CS, P=0.8688). The clinicopathological features of patients who underwent a prostatectomy were similar except for the diagnosis opportunity between the two groups. Progression-free survival rates were similar between the two groups (P=0.5630). A-bomb exposure was not a significant and independent predictor for worsening of progression-free prognosis by multivariate analysis (P=0.3763). A-bomb exposure does not appear to exert deleterious effects on the biological aggressiveness of PCa and the prognosis of patients with PCa.
1945年8月6日，一枚原子弹被投放到广岛。尽管众多研究调查了原子弹幸存者中的癌症发病率和死亡率，但只有少数研究涉及这些幸存者中的泌尿系统癌症。本研究的目的是调查原子弹幸存者中前列腺癌（PCa）的临床病理特征。1996年11月至2010年12月期间，对212名幸存者和595名对照患者的PCa临床病理特征及预后进行了回顾性分析。同时，对69名幸存者和162名对照患者的PCa手术治疗的组织病理学和临床结果也进行了评估。尽管与对照组相比，幸存者的诊断年龄更高（P = 0.0031），但与对照组相比，幸存者通过健康检查被诊断为PCa的可能性更大（P < 0.0001）。结果发现，与对照患者（521/595，87.6%；P = 0.0076）相比，幸存者发生转移的频率显著更低（199/212，93.9%）。在平均随访44个月后，对两组的预后进行了检查。两组的总生存期（OS）和PCa特异性生存期（CS）相似（OS，P = 0.2196；CS，P = 0.1017）。多因素分析未发现原子弹暴露是预后的独立预测因素（OS，P = 0.7800；CS，P = 0.8688）。除诊断时机外，两组接受前列腺切除术患者的临床病理特征相似。两组的无进展生存率相似（P = 0.5630）。多因素分析未发现原子弹暴露是无进展预后恶化的显著独立预测因素（P = 0.3763）。原子弹暴露似乎并未对PCa的生物学侵袭性及PCa患者的预后产生有害影响。
