Registry of Gastric Cancer Treatment Evaluation (REGATE): Regional differences in surgical approaches.

Abstract

4078 Background: Gastric cancer (GC) is one of the most common malignancies and surgical resection is the treatment of choice and the gold standard for resectable cases. The REGATE international disease registry was designed to report patterns of treatment for patients (pts) with GC. Assessment of surgical approaches and their geographic variations may help to improve pt care. Methods: From August 2004 to July 2008, 10,124 pts with primary GC were enrolled in REGATE; data were collected at an initial visit and after an observation period of <10 months. GC prevalence in the 22 participating countries informed sample size. Global and regional data for surgical treatment in pts with GC are reported. Baseline characteristics, staging, diagnosis and nonsurgical treatments are described elsewhere. Results: Analyses were performed for 9,965 pts (98%) who had documentation on actual treatment received in Europe (E), Asia-Pacific (AP), Latin America (LA), on the Indian subcontinent (IS) and in North Africa (NA). Overall, surgery with curative intent was the most planned (68%) and performed (70%) treatment. Higher proportions of pts in E (35%) and AP (36%) had surgery alone than in LA (18%), NA (14%), and on the IS (9%). Almost all pts in E, LA, and NA (98–100%) had open surgery compared with 86% in AP and 67% on the IS; the remaining pts had laparoscopic surgery. Surgical techniques varied by region, and 83–90% of pts who had surgery had lymph node (LN) dissection, except on the IS (56%). Pathological AJCC staging was I 27%, II 17%, III 30% and IV 25%. In E, LA, NA and on the IS, most pts were stage III (31–43%), whereas most AP pts (45%) were stage I. Conclusions: Analyses of data from the REGATE registry show that while surgery remains the primary treatment for GC, there are regional differences in the approaches to surgical treatment, incidence of curative surgery, the surgical techniques used, frequency of R0 resection and the extent of LN dissection. E AP LA IS NA N (%) 3,181 (32) 3,082 (31) 1,943 (19) 1,135 (11) 624 (6) Surgery: Planned (%) 72 79 65 37 56 Actual (%) 72 80 65 36 64 Patients with surgery (N) 2016 2278 988 307 311 Gastrectomy total/subtotal (%) 63/37 28/72 57/42 14/86 46/52 R0 resection (%) 82 89 82 83 66 D2 LN dissection (%) 66 77 62 34 29 Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration sanofi-aventis sanofi-aventis sanofi-aventis sanofi-aventis sanofi-aventis