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Annals of Oncology Advance Access published online on July 21, 2009
Annals of Oncology, doi:10.1093/annonc/mdp290
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© The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Race and ethnicity correlate with survival in patients with gastric adenocarcinoma

J. Kim1,2,*, C.-L. Sun1,3, B. Mailey2, C. Prendergast2, A. Artinyan2, S. Bhatia1,3, A. Pigazzi2 and J. D. I. Ellenhorn1,2

1 City of Hope Comprehensive Cancer Center
2 Department of Oncologic Surgery
3 Department of Population Sciences, City of Hope National Medical Center, Duarte, CA, USA

* Correspondence to: Dr J. Kim, City of Hope, 1500 East Duarte Road, Duarte, CA 91010, USA. Tel: +1-626-471-7100; Fax: +1-626-301-8865; E-mail: jokim{at}coh.org

Background: Asian centers have consistently reported superior gastric cancer outcomes. Our study examines gastric cancer survival among different races and ethnicities in a large, heterogeneous USA population.

Patients and methods: Patients with gastric adenocarcinoma treated in Los Angeles County from 1988 to 2006 were identified from the Los Angeles County Cancer Surveillance Program. Patients were categorized by race and ethnicity as White, Asian, Hispanic and Black.

Results: Of 13 084 patients, 39% were White, 22% Asian, 28% Hispanic, 11% Black and 2% other. Asian patients demonstrated higher survival than Whites, Hispanics and Blacks [median survival (MS) 16.3 versus 8.4, 8.7 and 7.9 months, respectively; log-rank P values < 0.001]. Multivariate Cox regression analysis showed that Asians had improved probability of survival [hazard ratio (HR) 0.76, 95% confidence interval (CI) 0.72–0.82; P < 0.001]. In patients who underwent curative-intent surgery, Asian patients demonstrated higher survival than Whites, Hispanics and Blacks (MS 32.7 versus 18.8, 19.9 and 18.9 months, respectively; log-rank P values < 0.001). Multivariate Cox regression analysis showed that Asians had improved probability of survival after surgery (HR 0.79, 95% CI 0.71–0.88; P < 0.001).

Conclusions: Asians with gastric adenocarcinoma have superior outcomes in Los Angeles County. These outcomes verify disparities in gastric cancer survival among different races and ethnicities independent of established clinical and pathologic factors.

CSP, disparity, gastric cancer, race and ethnicity

Received for publication April 14, 2009. Accepted for publication April 17, 2009.


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