BACKGROUND: There is ongoing debate whether extended lymphadenectomy improves survival in gastric cancer patients who undergo surgical resection. We previously observed that Korean-American patients had the highest overall survival in Los Angeles County. Our objective was to assess lymph node (LN) number and its impact on survival for Korean-American gastric cancer patients. METHODS: We utilized the National Cancer Institute's Surveillance, Epidemiology, and End Results registry to identify Korean-Americans with gastric adenocarcinoma treated with curative-intent gastrectomy between 1988 and 2008. We grouped patients according to examined LN number (1-15 and 16+) and compared characteristics. We performed similar analysis for white patients. RESULTS: Out of 982 Korean-American patients with gastric adenocarcinoma, most patients had 1-15 examined LNs (60 %). When we compared LN groups, we observed higher overall survival in the 1-15 group than the 16+ group (5-year survival, 59 % vs 52 %, respectively; p = 0.04). However, LN number was not prognostic of overall survival on stepwise Cox proportional hazards analysis. In contrast, LN number was prognostic for white patients. CONCLUSIONS: Although examined LN number may impact survival for white patients, outcomes of Korean-American gastric cancer patients were independent of LN number. Our data suggest that survival of Korean-American gastric cancer patients are comparable with outcomes from East Asian hospitals and may be independent of surgical technique.
BACKGROUND: There is ongoing debate whether extended lymphadenectomy improves survival in gastric cancerpatients who undergo surgical resection. We previously observed that Korean-American patients had the highest overall survival in Los Angeles County. Our objective was to assess lymph node (LN) number and its impact on survival for Korean-American gastric cancerpatients. METHODS: We utilized the National Cancer Institute's Surveillance, Epidemiology, and End Results registry to identify Korean-Americans with gastric adenocarcinoma treated with curative-intent gastrectomy between 1988 and 2008. We grouped patients according to examined LN number (1-15 and 16+) and compared characteristics. We performed similar analysis for white patients. RESULTS: Out of 982 Korean-American patients with gastric adenocarcinoma, most patients had 1-15 examined LNs (60 %). When we compared LN groups, we observed higher overall survival in the 1-15 group than the 16+ group (5-year survival, 59 % vs 52 %, respectively; p = 0.04). However, LN number was not prognostic of overall survival on stepwise Cox proportional hazards analysis. In contrast, LN number was prognostic for white patients. CONCLUSIONS: Although examined LN number may impact survival for white patients, outcomes of Korean-American gastric cancerpatients were independent of LN number. Our data suggest that survival of Korean-American gastric cancerpatients are comparable with outcomes from East Asian hospitals and may be independent of surgical technique.
Authors: J J Bonenkamp; J Hermans; M Sasako; C J van de Velde; K Welvaart; I Songun; S Meyer; J T Plukker; P Van Elk; H Obertop; D J Gouma; J J van Lanschot; C W Taat; P W de Graaf; M F von Meyenfeldt; H Tilanus Journal: N Engl J Med Date: 1999-03-25 Impact factor: 91.245
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Authors: A Cuschieri; S Weeden; J Fielding; J Bancewicz; J Craven; V Joypaul; M Sydes; P Fayers Journal: Br J Cancer Date: 1999-03 Impact factor: 7.640
Authors: Shinichi Fukuhara; Mariko Yabe; Marissa M Montgomery; Shinobu Itagaki; Steven T Brower; Martin S Karpeh Journal: J Gastrointest Surg Date: 2014-07-25 Impact factor: 3.452
Authors: Daniel D Kirchoff; Gary B Deutsch; Manabu Fujita; David Y Lee; Myung Shin Sim; Ji Hey Lee; Anton J Bilchik Journal: J Gastrointest Surg Date: 2015-08-26 Impact factor: 3.452
Authors: Audrey H Choi; Rebecca A Nelson; Shaila J Merchant; Jae Y Kim; Joseph Chao; Joseph Kim Journal: Gastrointest Endosc Date: 2015-11-10 Impact factor: 9.427