Comparison of factors influencing the prognosis of Japanese, German, and Dutch gastric cancer patients

Bonenkamp, Johannes J.; Velde, Cornelis J.H. van de; Kampschöer, G. H. M.; Hermans, J.; Hermanek, P.; Bemelmans, M. H. A.; Gouma, D. J.; Sasako, Mitsuru; Maruyama, Keiichi

doi:10.1007/bf01658714

Cited by 101 publications

(50 citation statements)

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“…Koreans had a remarkably low proportion of cardia gastric cancer, contributing further to their overall advantage. Asian race has been shown to be an independent prognostic factor for gastric cancer survival in many studies [6][7][8][9][10][11][12][13][14][15][16][17]. Here, we bolster those findings, demonstrating with multivariate analyses that each of the six major Asian ethnic groups has a survival advantage compared to NHWs.…”

Section: Discussionsupporting

confidence: 52%

“…Compared to non-Hispanic whites (NHWs), Asian Americans, as a whole, have higher gastric cancer incidence, but also have better survival outcomes [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. Previous research, while not conclusive, has linked the survival advantage of Asian Americans to tumors at a more distal anatomic site, diagnosis at earlier tumor stages, diagnosis at younger ages, and more aggressive treatment approaches [6][7][8][9][10][11][12][13][14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

“…Previous research, while not conclusive, has linked the survival advantage of Asian Americans to tumors at a more distal anatomic site, diagnosis at earlier tumor stages, diagnosis at younger ages, and more aggressive treatment approaches [6][7][8][9][10][11][12][13][14][15][16][17][18]. However, Asian Americans are heterogeneous, not only genetically, but also with respect to lifestyle, culture, immigration, and settlement experiences [19].…”

Section: Introductionmentioning

confidence: 99%

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Examining the gastric cancer survival gap between Asians and whites in the United States

et al. 2016

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Background Globally, Asian countries bear a disproportionate gastric cancer burden. Asian Americans, the fastest growing minority population in the US, have higher gastric cancer survival than non-Hispanic whites (NHWs) despite higher incidence. Benefitting from uniform cancer registry standards within the US, we examine for the first time the heterogeneity in the Asian American population, which may elucidate the causes of these disparities. Methods SEER gastric cancer data from 2000 to 2012 were used to calculate 5-year survival estimates for NHWs and the six largest Asian ethnicities. Multivariate analyses were performed to identify critical prognostic factors and survival disparities between Asian groups and NHWs. Results We analyzed 33,313 NHW and 8473 Asian gastric cancer cases. All Asian groups had significantly higher 5-year survival than NHWs, at 29.8%. Among Asians, Koreans and Vietnamese had the highest and lowest survival, at 45.4% and 35.7%, respectively. The Korean survival advantage was largely attributable to relatively high proportions of localized stage and low proportions of cardia tumors. After adjusting for major prognostic factors, the survival disadvantage of NHWs, while attenuated, remained significant in comparison to all Asian groups (HR: 1.33, 95% CI: 1.24-1.43; reference: Korean). The survival disparities within the Asian groups vanished with adjustment. Conclusions This study characterizes distinctive gastric cancer survival patterns among the six major Asian groups and NHWs in the US. The favorable survival for Koreans is largely attributable to specific clinical factors, particularly stage at diagnosis. The causes of the survival disadvantage for NHWs remain elusive.

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Section: Discussionsupporting

confidence: 52%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Examining the gastric cancer survival gap between Asians and whites in the United States

et al. 2016

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“…7 Although Hispanic ethnicity did not influence survival in the latter study, Asian race remained a favorable predictor of outcome. Stage migration, [8][9][10][11] treatment differences, [12][13][14] and differences in disease behavior [15][16][17][18][19] have been proposed to explain the differences in outcomes between Japanese patients and Western patients.…”

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confidence: 99%

The impact of ethnicity on the presentation and prognosis of patients with gastric adenocarcinoma

Al‐Refaie

Tseng

Patel-Parekh

et al. 2008

Cancer

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BACKGROUND.Regional‐based studies have indicated that ethnicity is associated with presentation and outcome in patients with gastric adenocarcinoma. To validate this observation in a large cohort, the authors of this report used the National Cancer Data Base (NCDB) to determine whether self‐reported ethnicity influences presentation and survival in this patient population.METHODS.Patient demographics, tumor‐related features, and treatment‐related features were analyzed by ethnicity. Univariate analyses were performed using the chi‐square test. Overall median and relative survival rates were examined by using the Kaplan‐Meier method. Cox proportional‐hazards models were used to identify the predictors of survival outcomes.RESULTS.Between 1995 and 2002, 81,095 cases of gastric adenocarcinoma were entered into the NCDB. There were 57,943 white patients (71.5%), 11,094 African‐American patients (13.7%), 5665 Hispanic patients (7%), 4736 Asian/Pacific Islander (API) patients (5.8%), and 1657 patients of other ethnicities (2%). Significant differences were observed according to ethnicity among the variables that were compared (all P < .01). In patients with stage I and II disease, the 5‐year relative survival rates for APIs (stage I, 77.2%; stage II, 48%) were more favorable than for whites (stage I, 58.7%; stage II, 32.8%), African Americans (stage I, 55.9%; stage II, 37.9%), and Hispanics (stage I, 60.8%; stage II, 39.3%). The overall median survival of APIs was more favorable than that of others (P < .01). Predictors of a better outcome were Asian race, female sex, younger age, earlier stage, lower grade, distal tumors, multimodality treatment, and care at a teaching hospital.CONCLUSIONS.Ethnicity was associated with differences in presentation and outcome of patients with gastric adenocarcinoma. APIs had a more favorable outcome than patients of other ethnicities. Further studies should target underlying biologic and socioeconomic factors to explain these differences. Cancer 2008. © 2008 American Cancer Society.

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“…To date, there has been no high-quality study that has reported biological differences in gastric cancer between Western and Japanese patients. Moreover, some studies report the similarity of gastric cancers in Western and Japanese patients [16,17]. Stage migration, due to more accurate nodal staging in Japan, can explain some part of the large differences in OS and RFS [18].…”

Section: Comparison Of Western and Japanese Trialsmentioning

confidence: 99%

Adjuvant chemotherapy with 5-FU or regimens including oral fluoropyrimidine for curable gastric cancer

Sasako

2009

Gastric Cancer

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tration of 45-Gy radiotherapy and fi ve courses of chemotherapy consisting of 5-fl uorouracil (5-FU) and leucovorin. Postoperative adjuvant chemoradiotherapy (CRT) showed a statistically signifi cant improvement of relapse-free survival (RFS) and overall survival (OS) for patients with gastric cancer undergoing curative surgery, compared with surgery alone as control. The 3-year OS after CRT was 50%, while that of the surgeryalone group was 41% (hazard ratio [HR], 1.35; 95% confi dence interval [CI], 1.09-1.66; P = 0.005). The chemotherapy used in this study, 5-FU and leucovorin, was a slightly-out-of-date regimen, but the low toxicity and high compliance of this treatment could have been the key to this successful study.The study had two major weak points. First, only 10% of patients underwent D2 dissection in spite of the recommendation of D2 dissection in the protocol, suggesting that poor local control by surgery was salvaged by radiotherapy. Secondly, 35 % of the irradiation plans had major or minor deviations, most of which could be revised before actual treatment by the central quality controller. The eventual rate of major deviation was 6.5%. This happened in the United States, where the standard level of radiotherapy seems to be much higher than that in most other countries, including Japan. This fact should be taken into consideration when this treatment is adopted in other countries.After this result came out, the standard treatment after potentially curative surgery for node-positive patients in the United States has been postoperative CRT. At present, we cannot see any United States clinical phase III trial of adjuvant treatment for potentially curable gastric cancer in the registry of the NCI (http:// www.clinicaltrial.gov.) MAGIC trial [3]Cunningham et al. [3] reported the results of the MAGIC trial, which was performed to evaluate the effi cacy of

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Comparison of factors influencing the prognosis of Japanese, German, and Dutch gastric cancer patients

Cited by 101 publications

References 21 publications

Examining the gastric cancer survival gap between Asians and whites in the United States

Examining the gastric cancer survival gap between Asians and whites in the United States

The impact of ethnicity on the presentation and prognosis of patients with gastric adenocarcinoma

Adjuvant chemotherapy with 5-FU or regimens including oral fluoropyrimidine for curable gastric cancer

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