Differences in gastric cancer survival between the U.S. and China
Background Previous comparisons of gastric cancer between the West and the East have focused predominantly on Japan and Korea, where early gastric cancer is prevalent, and have not included the Chinese experience, which accounts for approximately half the world's gastric cancer. Methods Patient...
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| Published in | Journal of surgical oncology Vol. 112; no. 1; pp. 31 - 37 |
|---|---|
| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Blackwell Publishing Ltd
01.07.2015
Wiley Subscription Services, Inc |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0022-4790 1096-9098 1096-9098 |
| DOI | 10.1002/jso.23940 |
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| Abstract | Background
Previous comparisons of gastric cancer between the West and the East have focused predominantly on Japan and Korea, where early gastric cancer is prevalent, and have not included the Chinese experience, which accounts for approximately half the world's gastric cancer.
Methods
Patient characteristics, surgical procedures, pathologic information, and survival were compared among gastric cancer patients who underwent curative intent gastrectomy at two large volume cancer centers in China and the US between 1995 and 2005.
Results
Median age and body mass index were significantly higher in US patients. The proportion of proximal gastric cancer was comparable. Gastric cancer patients in China had larger tumors and a later stage at presentation. The median number of positive lymph nodes was higher (5 vs 4, P < 0.02) despite a lower lymph node retrieval (16 vs 22, P < 0.001) in Chinese patients. The probability of death due to gastric cancer in Chinese patients was 1.7 fold of that in the US (P < 0.0001) after adjusting for important prognostic factors.
Conclusions
Even after adjusting for important prognostic factors Chinese gastric cancer patients have a worse outcome than US gastric cancer patients. The differences between Chinese and US gastric cancer are a potential resource for understanding the disease. J. Surg. Oncol. 2015 111:31–37. © 2015 Wiley Periodicals, Inc. |
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| AbstractList | Background Previous comparisons of gastric cancer between the West and the East have focused predominantly on Japan and Korea, where early gastric cancer is prevalent, and have not included the Chinese experience, which accounts for approximately half the world's gastric cancer. Methods Patient characteristics, surgical procedures, pathologic information, and survival were compared among gastric cancer patients who underwent curative intent gastrectomy at two large volume cancer centers in China and the US between 1995 and 2005. Results Median age and body mass index were significantly higher in US patients. The proportion of proximal gastric cancer was comparable. Gastric cancer patients in China had larger tumors and a later stage at presentation. The median number of positive lymph nodes was higher (5 vs 4, P<0.02) despite a lower lymph node retrieval (16 vs 22, P<0.001) in Chinese patients. The probability of death due to gastric cancer in Chinese patients was 1.7 fold of that in the US (P<0.0001) after adjusting for important prognostic factors. Conclusions Even after adjusting for important prognostic factors Chinese gastric cancer patients have a worse outcome than US gastric cancer patients. The differences between Chinese and US gastric cancer are a potential resource for understanding the disease. J. Surg. Oncol. 2015 111:31-37. © 2015 Wiley Periodicals, Inc. Background Previous comparisons of gastric cancer between the West and the East have focused predominantly on Japan and Korea, where early gastric cancer is prevalent, and have not included the Chinese experience, which accounts for approximately half the world's gastric cancer. Methods Patient characteristics, surgical procedures, pathologic information, and survival were compared among gastric cancer patients who underwent curative intent gastrectomy at two large volume cancer centers in China and the US between 1995 and 2005. Results Median age and body mass index were significantly higher in US patients. The proportion of proximal gastric cancer was comparable. Gastric cancer patients in China had larger tumors and a later stage at presentation. The median number of positive lymph nodes was higher (5 vs 4, P < 0.02) despite a lower lymph node retrieval (16 vs 22, P < 0.001) in Chinese patients. The probability of death due to gastric cancer in Chinese patients was 1.7 fold of that in the US (P < 0.0001) after adjusting for important prognostic factors. Conclusions Even after adjusting for important prognostic factors Chinese gastric cancer patients have a worse outcome than US gastric cancer patients. The differences between Chinese and US gastric cancer are a potential resource for understanding the disease. J. Surg. Oncol. 2015 111:31–37. © 2015 Wiley Periodicals, Inc. Previous comparisons of gastric cancer between the West and the East have focused predominantly on Japan and Korea, where early gastric cancer is prevalent, and have not included the Chinese experience, which accounts for approximately half the world's gastric cancer. Patient characteristics, surgical procedures, pathologic information, and survival were compared among gastric cancer patients who underwent curative intent gastrectomy at two large volume cancer centers in China and the US between 1995 and 2005. Median age and body mass index were significantly higher in US patients. The proportion of proximal gastric cancer was comparable. Gastric cancer patients in China had larger tumors and a later stage at presentation. The median number of positive lymph nodes was higher (5 vs 4, P < 0.02) despite a lower lymph node retrieval (16 vs 22, P < 0.001) in Chinese patients. The probability of death due to gastric cancer in Chinese patients was 1.7 fold of that in the US (P < 0.0001) after adjusting for important prognostic factors. Even after adjusting for important prognostic factors Chinese gastric cancer patients have a worse outcome than US gastric cancer patients. The differences between Chinese and US gastric cancer are a potential resource for understanding the disease. Previous comparisons of gastric cancer between the West and the East have focused predominantly on Japan and Korea, where early gastric cancer is prevalent, and have not included the Chinese experience, which accounts for approximately half the world's gastric cancer.BACKGROUNDPrevious comparisons of gastric cancer between the West and the East have focused predominantly on Japan and Korea, where early gastric cancer is prevalent, and have not included the Chinese experience, which accounts for approximately half the world's gastric cancer.Patient characteristics, surgical procedures, pathologic information, and survival were compared among gastric cancer patients who underwent curative intent gastrectomy at two large volume cancer centers in China and the US between 1995 and 2005.METHODSPatient characteristics, surgical procedures, pathologic information, and survival were compared among gastric cancer patients who underwent curative intent gastrectomy at two large volume cancer centers in China and the US between 1995 and 2005.Median age and body mass index were significantly higher in US patients. The proportion of proximal gastric cancer was comparable. Gastric cancer patients in China had larger tumors and a later stage at presentation. The median number of positive lymph nodes was higher (5 vs 4, P < 0.02) despite a lower lymph node retrieval (16 vs 22, P < 0.001) in Chinese patients. The probability of death due to gastric cancer in Chinese patients was 1.7 fold of that in the US (P < 0.0001) after adjusting for important prognostic factors.RESULTSMedian age and body mass index were significantly higher in US patients. The proportion of proximal gastric cancer was comparable. Gastric cancer patients in China had larger tumors and a later stage at presentation. The median number of positive lymph nodes was higher (5 vs 4, P < 0.02) despite a lower lymph node retrieval (16 vs 22, P < 0.001) in Chinese patients. The probability of death due to gastric cancer in Chinese patients was 1.7 fold of that in the US (P < 0.0001) after adjusting for important prognostic factors.Even after adjusting for important prognostic factors Chinese gastric cancer patients have a worse outcome than US gastric cancer patients. The differences between Chinese and US gastric cancer are a potential resource for understanding the disease.CONCLUSIONSEven after adjusting for important prognostic factors Chinese gastric cancer patients have a worse outcome than US gastric cancer patients. The differences between Chinese and US gastric cancer are a potential resource for understanding the disease. |
| Author | Song, Kyo Young Park, Cho Hyun Coit, Daniel G. Strong, Vivian E. Gonen, Mithat Brennan, Murray F. Hsu, Meier Selby, Luke V. Wu, Ai-wen Ji, Jia-fu |
| AuthorAffiliation | Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Surgery, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China Departments of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY Department of Surgery, Seoul St. Mary’s Hospital, Seoul, South Korea Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY |
| AuthorAffiliation_xml | – name: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Surgery, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China – name: Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY – name: Departments of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY – name: Department of Surgery, Seoul St. Mary’s Hospital, Seoul, South Korea |
| Author_xml | – sequence: 1 givenname: Vivian E. surname: Strong fullname: Strong, Vivian E. email: Correspondence to: Vivian E Strong MD, FACS, Department of Surgery, Gastric and Mixed Tumor Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065.Fax: +212 639 5056. , strongv@mskcc.org organization: Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York – sequence: 2 givenname: Ai-wen surname: Wu fullname: Wu, Ai-wen organization: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Surgery, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China – sequence: 3 givenname: Luke V. surname: Selby fullname: Selby, Luke V. organization: Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York – sequence: 4 givenname: Mithat surname: Gonen fullname: Gonen, Mithat organization: Departments of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York – sequence: 5 givenname: Meier surname: Hsu fullname: Hsu, Meier organization: Departments of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York – sequence: 6 givenname: Kyo Young surname: Song fullname: Song, Kyo Young organization: Department of Surgery, Seoul St. Mary's Hospital, Seoul, South Korea – sequence: 7 givenname: Cho Hyun surname: Park fullname: Park, Cho Hyun organization: Department of Surgery, Seoul St. Mary's Hospital, Seoul, South Korea – sequence: 8 givenname: Daniel G. surname: Coit fullname: Coit, Daniel G. organization: Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York – sequence: 9 givenname: Jia-fu surname: Ji fullname: Ji, Jia-fu organization: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Surgery, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China – sequence: 10 givenname: Murray F. surname: Brennan fullname: Brennan, Murray F. organization: Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York |
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| Notes | National 863 High Tech R&D Program of China - No. 2006AA02A402 ArticleID:JSO23940 Soudavar Memorial Fellowship in Memorial Sloan-Kettering Cancer Center, Natural Science Foundation of China - No. 81071983 istex:72338EF2EB43227800DEA23950756B70E35B49EA ark:/67375/WNG-H4HQM3WV-N NIH Core Grant - No. P30 CA 008748 Beijing Municipal Science & Technology Commission NOVA program - No. 2007B-057 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 ObjectType-Article-2 ObjectType-Feature-1 content type line 23 Vivian E Strong MD and Ai-wen Wu MD contributed equally to the study and should be considered co-first authors |
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Previous comparisons of gastric cancer between the West and the East have focused predominantly on Japan and Korea, where early gastric cancer is... Previous comparisons of gastric cancer between the West and the East have focused predominantly on Japan and Korea, where early gastric cancer is prevalent,... Background Previous comparisons of gastric cancer between the West and the East have focused predominantly on Japan and Korea, where early gastric cancer is... |
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| SubjectTerms | Adenocarcinoma - epidemiology Adenocarcinoma - mortality Adenocarcinoma - pathology Adenocarcinoma - surgery Adult Aged Aged, 80 and over China - epidemiology Female Follow-Up Studies gastrectomy Gastrectomy - mortality gastric cancer Humans Male Middle Aged Neoplasm Staging Prognosis Stomach Neoplasms - epidemiology Stomach Neoplasms - mortality Stomach Neoplasms - pathology Stomach Neoplasms - surgery Survival Rate United States - epidemiology Young Adult |
| Title | Differences in gastric cancer survival between the U.S. and China |
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