Abstract
5 Background: Gastric cancer is one of the leading causes of cancer related deaths worldwide with the incidence declining in the United States. However the prognosis remains poor with variable survivals being reported among different races. We analyzed the effect of race on patterns of disease presentation and survival rates using the Surveillance, Epidemiology, and End Results (SEER) database. Methods: A total of 9,851 patients were diagnosed with gastric cancer from year 2004 to 2007 were identified from SEER database. Age, race, TNM staging, grade, treatment modalities utilized and cancer specific survival was collected. Results: Out of 9,851 patients, 64.63% were white, 12.17% were black, and 13.04% were Asian-Pacific islanders. Median age was 73 years for whites, 70 years in blacks, and 71 years in Asians. Sex distribution amongst races was more or less similar with 58.83% of whites, 59.47% of blacks, and 54.24% of Asians being men. 23.62% of whites had T1 lesions, 28.10% had T2, 19.58% were T3 and 28.70% had T4 lesions. 26.76% of blacks presented with T1 lesions, 26.63% with T2, 16.08% with T3 and 30.53% with T4. 18.69% of Asians had T1 lesions, 26.84% with T2, 23.44% had T3 and 31.03% had T4 lesions. 37.80% of whites, 36.70% of blacks, and 44.44% of Asians had lymph node involvement. Tumor grade was similar among all races. Surgery was performed in 31.49% of whites, 33.13% of blacks, and 40.48% of Asians. 14.68% of whites, 14.10% of blacks, and 19.43 % of all Asians underwent radiation therapy. Median overall survival in localized disease was 44 months, 43 months and 98 months (p < 0.0001) while in regional disease it was 16 months, 15 months and 23 months in whites, blacks and Asians respectively (p < 0.0001). Median survival in distant disease was 4 months in both whites and blacks; it was 5 months in Asians (p < 0.0001). Conclusions: Cancer-specific survival in gastric carcinoma is significantly better in localized, regional and metastatic disease in Asians when compared to whites and blacks independent of T stage, grade, nodal involvement and treatment modalities utilized. The reason for this observation is unclear, exposure and genetic factors are potential causes and this needs to be investigated. No significant financial relationships to disclose.
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