title: The long-term outcome of atomic bomb survivors with gastric carcinoma.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Results of surgical treatment of gastric cancer were reviewed in 231 atomic bomb survivors and 759 control patients between 1995 and 2006.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Surgery, Hiroshima Atomic Bomb Survivors Hospital, Hiroshima, Japan. mayama@hiroshima-med.jrc.or.jp
authors.forename: Manabu
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Ayumi
authors.initials: A
authors.lastname: Matsuyama
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Kameyama
authors.forename: Masahiro
authors.initials: M
authors.lastname: Okamoto
authors.forename: Jin
authors.initials: J
authors.lastname: Okazaki
authors.forename: Tohru
authors.initials: T
authors.lastname: Utsunomiya
authors.forename: Shinichi
authors.initials: S
authors.lastname: Tsutsui
authors.forename: Teruyoshi
authors.initials: T
authors.lastname: Ishida
mesh_terms: D000367:Age Factors; D000368:Aged; D002277:Carcinoma / Q000401:mortality / Q000473:pathology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000453:epidemiology; D054043:Nuclear Weapons; D011379:Prognosis; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology; D017741:Survivors