Registry of Gastric Cancer Treatment Evaluation (REGATE): Staging and diagnosis of 10,124 patients (pts).

Abstract

4090 Background: The second most common cause of cancer death worldwide is gastric cancer (GC) and it is often diagnosed at a late stage. The REGATE international disease registry was designed to describe regional patterns of treatment for pts with GC. Assessment of geographic differences in staging and diagnosis may help to improve pt care. Methods: Pts with newly diagnosed primary GC were enrolled from August 2004 to July 2008; data were collected at an initial visit and <10 months later. Target sample size was calculated according to GC prevalence in the 22 participating countries. Baseline staging and diagnosis are described globally and by region. Baseline pt and tumor characteristics, and surgical and non-surgical treatments are reported elsewhere. Results: Overall, 10,124 pts were enrolled in 5 regions: Europe (E) 32%, Asia-Pacific (AP) 31%, Latin America (LA) 20%, Indian subcontinent (IS) 12%, and North Africa (NA) 6%. AJCC staging was the most frequently used classification (99%). In AP, GC was diagnosed most frequently at stage I; pts in other regions were mostly diagnosed at stage IV. Stage III rates were similar in E, AP, and LA (19–21%), higher on the IS (30%), and lower in NA (13%). Histopathologic type was assessed using WHO, Lauren, and/or Ming classifications in 75%, 60%, and 31% of all pts, respectively. The most common WHO subtype was signet ring cell (41%). Tubular subtype occurred in 35% (LA) and 40% (AP) of pts vs. <10% of pts in other regions. Diffuse and intestinal Lauren subtypes were comparable in E, LA, and the IS; diffuse subtype was most common in AP (56%) and NA (60%). More pts on the IS (77%) had a grade 3 tumor vs. other regions (42–49%). CT scan was the most frequently used staging method (76%), but was used less often in E (47%) vs. other regions (86–94%). Conclusions: Regional differences were observed for staging and diagnosis in REGATE. Diagnosis with stage I disease occurred most often in AP; metastatic disease was more common in other regions. Staging and histopathologic classifications, and disease investigation techniques also varied by region. E AP LA IS NA N (%) 3202 (32) 3119 (31) 1988 (20) 1191 (12) 624 (6) AJCC (%) 98 99 99 99 98 Japanese (%) 25 53 21 9 36 AJCC stage I/IV (%) 12/42 38/28 16/36 6/49 18/57 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