Takanobu Yamada1, Takaki Yoshikawa2, Masataka Taguri3, Tsutomu Hayashi1, Toru Aoyama1, Henry M Sue-Ling4, Kiran Bonam5,6, Jeremy D Hayden4, Heike I Grabsch7. 1. Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, Japan. 2. Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, Japan. yoshikawat@kcch.jp. 3. Department of Biostatistics and Epidemiology, Graduate School of Medicine, Yokohama City University, 4-57 Urafune, MInami-ku, Yokohama, Kanagawa, Japan. 4. Department of Upper Gastrointestinal Surgery, Leeds Teaching Hospital NHS Trust, St James's Institute of Oncology, Bexley Wing, St James's University Hospital, Leeds, UK. 5. Department of Radiology, Newcastle upon Tyne Hospitals NHS Trust, Newcastle, UK. 6. Section of Pathology and Tumor Biology, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK. 7. Department of Pathology, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands. H.Grabsch@maastrichtuniversity.nl.
Abstract
BACKGROUND: Previous studies comparing survival between gastric cancer (GC) patients from the West and the East were based on the assumption that background factors and prognostic factors were identical. The aim of the current study was to compare the survival of GC patients from the UK and Japan using weighted propensity score analysis after identifying all different background factors. METHODS: Data from 464 patients from the Leeds Teaching Hospital NHS Trust, Leeds, UK (LTHT), and 465 patients from the Kanagawa Cancer Center Hospital, Yokohama, Japan (KCCH), who had surgery for GC were analyzed. Prognostic factors for overall survival (OS) and cancer-specific survival (CSS) were identified by univariate and multivariate analyses. Survival was compared by propensity score weighting after adjusting for all significantly different background factors. RESULTS: Most background factors were different between LTHT and KCCH patients. Unadjusted stage-specific OS and CSS were significantly better in KCCH. Independent prognostic factors for unadjusted OS and CSS were pT and pN in KCCH and in addition tumor location, pancreatectomy, resection margin status and number of examined lymph nodes in LTHT. Even after adjusting for all background characteristics, survival remained better in KCCH. CONCLUSIONS: These results suggest that differences in background factors are unable to fully explain the survival difference of GC patients between UK and Japan. Comprehensive studies into the biology of GC and/or host factors are needed to fully understand the survival difference.
BACKGROUND: Previous studies comparing survival between gastric cancer (GC) patients from the West and the East were based on the assumption that background factors and prognostic factors were identical. The aim of the current study was to compare the survival of GC patients from the UK and Japan using weighted propensity score analysis after identifying all different background factors. METHODS: Data from 464 patients from the Leeds Teaching Hospital NHS Trust, Leeds, UK (LTHT), and 465 patients from the Kanagawa Cancer Center Hospital, Yokohama, Japan (KCCH), who had surgery for GC were analyzed. Prognostic factors for overall survival (OS) and cancer-specific survival (CSS) were identified by univariate and multivariate analyses. Survival was compared by propensity score weighting after adjusting for all significantly different background factors. RESULTS: Most background factors were different between LTHT and KCCH patients. Unadjusted stage-specific OS and CSS were significantly better in KCCH. Independent prognostic factors for unadjusted OS and CSS were pT and pN in KCCH and in addition tumor location, pancreatectomy, resection margin status and number of examined lymph nodes in LTHT. Even after adjusting for all background characteristics, survival remained better in KCCH. CONCLUSIONS: These results suggest that differences in background factors are unable to fully explain the survival difference of GC patients between UK and Japan. Comprehensive studies into the biology of GC and/or host factors are needed to fully understand the survival difference.
Entities:
Keywords:
East versus West; Gastric cancer; Prognosis; Propensity score weighting
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