Effects of sex and racial/ethnic group on the pattern of gastric cancer localization

Yao, James C.; Schnirer, Isac I.; Reddy, Satish; Chiang, Silvia S.; Najam, Azmeena; Yu, C. T.; Giacco, G. Del; Hess, Kenneth R.; Rashid, Asif; Xie, Keping; Lynch, Patrick M.; Ajani, Jaffer A.

doi:10.1007/s101200200036

Cited by 45 publications

(38 citation statements)

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“…Multiple studies have examined ethnicityrelated differences in survival after gastrectomy, showing prognoses to be superior for Asian and Hispanic patients over their Caucasian and African-American counterparts (17)(18)(19)(20)(21)(22)(23). This trend has been attributed to differences in patterns of disease presentation (i.e., proximal versus distal tumor location), and cultural differences in life style and social habits (17)(18)(19)(20)(21)(22). Interestingly, 2 studies found that patterns of tumor localization among Asians were more similar to the patterns among African Americans than among Caucasians (20)(21).…”

Section: Discussionmentioning

confidence: 99%

“…This trend has been attributed to differences in patterns of disease presentation (i.e., proximal versus distal tumor location), and cultural differences in life style and social habits (17)(18)(19)(20)(21)(22). Interestingly, 2 studies found that patterns of tumor localization among Asians were more similar to the patterns among African Americans than among Caucasians (20)(21). Recognizing the importance of tumor location, that is, proximal tumors tend to follow a more aggressive course, we controlled for location near GE junction in our multivariate analysis.…”

Section: Discussionmentioning

confidence: 99%

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Demographic Disparities in Patterns of Care and Survival Outcomes for Patients with Resected Gastric Adenocarcinoma

Stessin

Sherr

2011

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Several reports showed incomplete adoption of adjuvant radiotherapy (RT) for resectable gastric cancer since the publication of Intergroup 0116 trial results. The aims of this study were to identify demographic factors associated with omission of adjuvant RT and assess the impact of this omission on survival.Methods: SEER database was queried for cases of resected gastric cancer. Multivariate analyses with logistic and Cox regressions were used to examine (a) likelihood of receiving adjuvant RT for different patient and county demographics and (b) effect of demographics on survival outcomes.Results: A total of 7,348 patients met the study criteria. Adjuvant RT was used in 33.1% of cases diagnosed in 1998-2001 and in 45.3% of cases in 2002-2007 (P < 0.001). Controlling for independent covariates, African Americans were 8.9% less likely to receive adjuvant RT than Caucasians or Asians (P < 0.001). Correspondingly, overall survival rates were significantly lower for African Americans than other races (HR ¼ 1.38, P < 0.001). Furthermore, both the likelihood of receiving RT and the survival rates were significantly affected by county demographics: percent of population without high school education, percent of households below the poverty line, and median household income. Survival rates were highest among Asians, but this finding did not reflect more frequent use of RT.Conclusions: Race and socioeconomic factors are significant predictors of treatment and survival outcomes for patients with resectable gastric cancer.Impact: The findings of this and similar studies may aide the medical community in designing more effective strategies to ameliorate the standards of care nationwide. Cancer Epidemiol Biomarkers Prev; 20(2); 223-33.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Demographic Disparities in Patterns of Care and Survival Outcomes for Patients with Resected Gastric Adenocarcinoma

Stessin

Sherr

2011

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…Because our current study is representative nationally, these findings also may be attributed to the typically advanced nature of proximal tumors at presentation or to the possibility that these cancers constitute a different disease. 6,24,25 Yao et al 7 assessed the characteristics and outcome of 301 Hispanic patients with gastric adenocarcinoma among 1897 such patients who were seen at the University of Texas M. D. Anderson Cancer Center. In that study, Hispanics were more likely to be younger, to have distal tumors, and to develop peritoneal metastasis than other ethnicities.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4][5][6][7] Over the past 5 years, 2 population-based analyses, 1 conducted in British Columbia, Canada, and the other in southern California, revealed that self-identified Asian race/ethnicity, including patients of Asian descent, had distinct tumor-related features and a more favorable outcome in compared with individuals from other ethnic backgrounds with the disease. 3,5 Furthermore, a recent retrospective study from the University of Texas M. D. Anderson Cancer Center demonstrated that Hispanic patients with gastric adenocarcinoma displayed unique clinicopathologic features.…”

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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

Self Cite

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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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“…Tumors located in the proximal third of the stomach are more common in Western countries and patients typically present with more advanced stage disease often due to lack of government supported screening programs (3)(4)(5)(6)(7)(8). The incidence of proximal gastric cancer is on the rise in the United States, most likely related to the obesity epidemic in the United States and prevalence of gastroesophageal reflux disease (9,10).…”

Section: Introductionmentioning

confidence: 99%

Minimally invasive surgery for gastric cancer in USA: current status and future perspectives

Russo¹,

Strong²

2017

Transl. Gastroenterol. Hepatol.

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Abstract:The World Health Organization (WHO) has declared gastric carcinoma a global health concern and gastric cancer remains the third leading cause of cancer deaths worldwide. With the rising incidence of gastric cancer, a body of both retrospective and randomized data has emerged since the early 1990's evaluating the role of minimally invasive platforms in the management of gastric cancer. While Eastern studies have shown that the laparoscopic approach is safe and feasible for advanced gastric cancer in Eastern patients, it is not clear whether this is true for patients in the West. Differences in tumor biology, stage at presentation, institutional volume, and surgeon experience all may impact the efficacy and widespread utilization of minimally invasive approaches in regions where gastric cancer is less prevalent. The majority of studies have pointed to a number of improvements associated with minimally invasive approaches including decreased blood loss, shorter length of hospital stay, lower analgesic requirements, decreased minor complications, and faster recovery without any significant difference in overall or disease specific survival (DSS). The benefits associated with minimally invasive approaches and evidence supporting similar oncologic outcomes compared to the traditional open approach will hopefully expand the indications for minimally invasive surgery in the management of gastric cancer. In the United States, results following initial experiences with minimally invasive techniques, including robotic platforms, have revealed promising results.Well-established laparoscopic and robotic techniques are emerging, particularly from high volume United States institutions, which will hopefully pave the way for increased utilization of minimally invasive surgery for gastric cancer in the West.

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Effects of sex and racial/ethnic group on the pattern of gastric cancer localization

Cited by 45 publications

References 16 publications

Demographic Disparities in Patterns of Care and Survival Outcomes for Patients with Resected Gastric Adenocarcinoma

Demographic Disparities in Patterns of Care and Survival Outcomes for Patients with Resected Gastric Adenocarcinoma

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

Minimally invasive surgery for gastric cancer in USA: current status and future perspectives

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