BACKGROUND: Survival after curative gastrectomy for gastric cancer varies depending on region. The 5-year survival rates in Western trials reach 36-47% compared with 40-60% in Japanese studies. We analyzed the outcomes of Asian and non-Asian patients at a single Australian institution. METHODS: We analyzed a prospectively kept database of patients following gastric resection between 1994 and 2010 at a tertiary Australian hospital. Overall survival was the primary endpoint. RESULTS: A total of 160 patients underwent a R0 gastrectomy with curative intent, of whom 26 (16%) were of Asian descent. Asian patients had a significantly younger age at diagnosis (60 ± 16 vs. 70 ± 11, p < 0.05) and longer overall survival (log-rank p = 0.018). Poor prognostic factors common to both groups included increased tumor length, higher T-score, higher LN ratio, poor tumor differentiation, and the presence of perineural or perivascular invasion. Multivariate analysis showed that non-Asian patients, higher T-score, higher N-score, and perivascular involvement were all independent predictors of poorer outcome. CONCLUSIONS: This study shows superior overall survival in Asian patients despite similar clinicopathological and treatment data. The younger age at diagnosis in Asian patients may suggest a different disease process between ethnicities. Targeted therapies based on population-specific tumor biology may potentially be beneficial.
BACKGROUND: Survival after curative gastrectomy for gastric cancer varies depending on region. The 5-year survival rates in Western trials reach 36-47% compared with 40-60% in Japanese studies. We analyzed the outcomes of Asian and non-Asian patients at a single Australian institution. METHODS: We analyzed a prospectively kept database of patients following gastric resection between 1994 and 2010 at a tertiary Australian hospital. Overall survival was the primary endpoint. RESULTS: A total of 160 patients underwent a R0 gastrectomy with curative intent, of whom 26 (16%) were of Asian descent. Asian patients had a significantly younger age at diagnosis (60 ± 16 vs. 70 ± 11, p < 0.05) and longer overall survival (log-rank p = 0.018). Poor prognostic factors common to both groups included increased tumor length, higher T-score, higher LN ratio, poor tumor differentiation, and the presence of perineural or perivascular invasion. Multivariate analysis showed that non-Asian patients, higher T-score, higher N-score, and perivascular involvement were all independent predictors of poorer outcome. CONCLUSIONS: This study shows superior overall survival in Asian patients despite similar clinicopathological and treatment data. The younger age at diagnosis in Asian patients may suggest a different disease process between ethnicities. Targeted therapies based on population-specific tumor biology may potentially be beneficial.
Authors: Vivian E Strong; Kyo Young Song; Cho Hyun Park; Lindsay M Jacks; Mithat Gonen; Manish Shah; Daniel G Coit; Murray F Brennan Journal: Ann Surg Date: 2010-04 Impact factor: 12.969
Authors: Paola Bertuccio; Liliane Chatenoud; Fabio Levi; Delphine Praud; Jacques Ferlay; Eva Negri; Matteo Malvezzi; Carlo La Vecchia Journal: Int J Cancer Date: 2009-08-01 Impact factor: 7.396
Authors: Natalie Liu; Daniela Molena; Miloslawa Stem; Amanda L Blackford; David B Sewell; Anne O Lidor Journal: J Gastrointest Surg Date: 2018-02-05 Impact factor: 3.452