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%.
Medicina (Kaunas, Lithuania). 2019 Apr 14*** epublish ***
Jen-Pin Chuang, Yen-Chien Lee, Jenq-Chang Lee, Chin-Li Lu, Chung-Yi Li
Institute of Clinical Medicine, National Cheng Kung University College of Medicine, Tainan 70101, Taiwan. ., Department of Oncology, Tainan Hospital, Ministry of Health and Welfare, Tainan 70043, Taiwan. ., Department of Surgery, National Cheng Kung University College of Medicine, Tainan 70101, Taiwan. ., Institute of Food Safety, College of Agriculture and Natural Resources, National Chung Hsing University, Taichung 40249, Taiwan. ., Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan. .