Patients of Asian descent with gastric cancer treated in the United States: Comparative characteristics and survival outcomes.

Abstract

10 Background: Asian gastric cancer trials often show better outcomes than similar Western trials suggesting a possible difference in disease characteristics or biology. Large databases can be used to assess whether ethnic differences persist in the United States. Methods: The National Cancer Database was queried to examine disease characteristics, treatment utilization, and outcomes for gastric cancer from 2004-2013 for Asian vs. non-Asian patients. Patients were excluded with inadequate follow-up, unknown staging or race. Cox proportional hazards model was used to assess hazard ratio (HR) of death. Results: 101,426 patients were analyzed (6,994 Asians, 94,432 non-Asians). Asian patients were more likely to be female, younger, treated at academic centers, early stage, lower co-morbidity score, and high grade vs. non-Asian (Chi-square, all p<0.001). Asian patients were less likely to receive chemotherapy or radiation or have a positive margin. HRs of death (adjusted for age, sex, facility, histology, insurance, co-morbidity score, margin, grade, surgery, radiation, and chemotherapy) for Asian patients are shown in the table. Further dividing by most represented Asian sub-groups showed differences between countries of origin. Conclusions: Imbalances exist in clinical features and treatment utilization in Asian patients compared to non-Asians. After adjustment, Asian race is associated with higher overall survival. Adjusted sub-group analyses show survival differences by country of origin, suggesting biological variability. [Table: see text]