Differences in stage-stratified gastric cancer survival have been reported between Asian and Western populations.
In this study, researchers from North America examined differences in presentation and outcomes among Asian and non-Asian patients at a Canadian institution.
The team reviewed 2043 patients with gastric adenocarcinoma, between 1978 and 1997. Of these patients, 159 were Asian.
|Asian patients were younger, and had a greater proportion of signet ring cell histology.|
|Journal of Clinical Oncology|
The researchers measured overall survival was examined by the Kaplan-Meier method. They also used Cox proportional hazards to identify whether Asian ethnicity had independent prognostic significance for survival.
The research team found that median survival was 13.1 months for Asians and 11.1 months for non-Asians.
The team found that Asian patients were younger, and had a greater proportion of signet ring cell histology. However, Asian patients were less likely to have proximal disease, and signet ring cell histology did not adversely affect survival.
They determined, using multivariable analysis, that proximal location, poor differentiation, and extent of disease were independently associated with worse survival.
Survival was improved with curative resection, palliative resection, and palliative chemotherapy.
The team found that Asian ethnicity was not independently associated with survival.
A similar proportion of patients underwent curative resection. However, an interaction was identified between Asian ethnicity and efficacy of resection. The team found that Asians achieved a greater benefit, compared with non-Asians, even when data was adjusted for age and location.
Dr Sharlene Gill's team concluded, "The disparity between Eastern and Western gastric cancer survival is not explained by the hypothesis of ethnicity-related differences in tumor biology".
"Although it is not an independent predictor of survival, Asian ethnicity is associated with distinct characteristics at presentation and more favorable outcomes after curative surgery".