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A Population-Based Study of Secondary Prostate Cancer Risk after Radiotherapy in Male Patients with Rectal Cancer: A Retrospective Cohort Study

1
Institute of Clinical Medicine, National Cheng Kung University College of Medicine, Tainan 70101, Taiwan
2
Department of Surgery, Puzi Hospital, Ministry of Health and Welfare, Chiayi County 61347, Taiwan
3
Department of Oncology, Tainan Hospital, Ministry of Health and Welfare, Tainan 70043, Taiwan
4
Institute of Internal Medicine, National Cheng Kung University College of Medicine, Tainan 70101, Taiwan
5
Department of Surgery, National Cheng Kung University College of Medicine, Tainan 70101, Taiwan
6
Institute of Food Safety, College of Agriculture and Natural Resources, National Chung Hsing University, Taichung 40249, Taiwan
7
Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
8
Department of Public Health, College of Public Health, China Medical University, Taichung 40402, Taiwan
*
Author to whom correspondence should be addressed.
Medicina 2019, 55(4), 104; https://doi.org/10.3390/medicina55040104
Received: 11 December 2018 / Revised: 26 February 2019 / Accepted: 10 April 2019 / Published: 14 April 2019
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PDF [919 KB, uploaded 17 April 2019]
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Abstract

Background and objective: Risk of secondary prostate cancer after radiation therapy among patients with rectal cancer remains undetermined. Given an increased incidence of rectal cancer in younger people and improved survival for rectal cancer patients who received radiation therapy, the potential risk of secondary prostate cancer needs to be further investigated. Materials and Methods: Male patients (n = 11,367) newly diagnosed rectal cancer and who underwent abdominoperineal resection (APR) or low anterior resection (LAR) from 1 January, 1998 to 31 December, 2010 were identified from Taiwan National Health Insurance Research Database. The incidence and relative risk of secondary prostate cancer in study patients with (n = 1586) and without (n = 9781) radiotherapy within one year after rectal cancer diagnosis were compared using a competing-risks analysis. Results: Rectal cancer patients with radiotherapy were at a significantly decreased risk of developing prostate cancer, with a hazard ratio (HR) of 0.41 (95% confidence interval = 0.20–0.83) after adjustment for age. Analysis of the risk estimated for various follow-up lengths suggested that a decreasing HR was seen through the period followed-up and that there was a trend of decreasing prostate cancer risk with time after radiotherapy. Conclusions: Radiotherapy was significantly associated with decreased risk of secondary prostate cancer among rectal cancer patients, by a magnitude of 59%. View Full-Text
Keywords: rectal cancer; radiotherapy; prostate cancer rectal cancer; radiotherapy; prostate cancer
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Chuang, J.-P.; Lee, Y.-C.; Lee, J.-C.; Lu, C.-L.; Li, C.-Y. A Population-Based Study of Secondary Prostate Cancer Risk after Radiotherapy in Male Patients with Rectal Cancer: A Retrospective Cohort Study. Medicina 2019, 55, 104.

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