Trends in Clinicopathologic Characteristics and Prognostic Predictors of Survival Outcome in Black Patients with Gastric Carcinoma: A Single Institution's Experience

Background Age, gender, and ethnic group-related differences influence the outcome of gastric cancer. Our aim was to analyze the trends and association of clinicopathologic characteristics and prognostic factors of gastric cancer in black patients over a period of 28 y. Methods A retrospective analy...

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Published in:The Journal of surgical research 2009-10, Vol.156 (2), p.325-332
Main Authors: Ihemelandu, Chukwuemeka U, DeWitty, R.L, Leffall, L.D, Suryanarayana, M.S, Frederick, Wayne A
Format: Article
Language:English
Subjects:
Adenocarcinoma - mortality
Adenocarcinoma - pathology
Adenocarcinoma - therapy
Adult
African Americans
Aged
Biological and medical sciences
Female
gastric cancer
Gastroenterology. Liver. Pancreas. Abdomen
General aspects
Humans
Male
Medical sciences
Middle Aged
Prognosis
Registries
Retrospective Studies
Stomach Neoplasms - mortality
Stomach Neoplasms - pathology
Stomach Neoplasms - therapy
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Surgery
Survival Analysis
Tumors
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Summary:Background Age, gender, and ethnic group-related differences influence the outcome of gastric cancer. Our aim was to analyze the trends and association of clinicopathologic characteristics and prognostic factors of gastric cancer in black patients over a period of 28 y. Methods A retrospective analysis of all black patients treated for gastric cancer from 1979 to 2007 at Howard University Teaching Hospital. This period was divided into two time frames, 1979–1993 and 1994–2007. Results Of 286 patients in our study, there were 160 (55.9%) males versus 126 (44.1%) females. For the period 1979–1993, there were a total of 169 (59.1%) patients versus 117 (40.9%) for 1994–2007. A significant increase in the incidence of cardia/fundus tumors and stage IV tumors was noted between the two periods ( P < 0.02, P < 0.004), 8.9% versus 12% and 71.4% versus 50.8%. The median survival time for the period 1979–1993 was 30.5 mo versus 39.2 mo for 1994–2007. The median survival time for males was 35.7 mo versus 34.9 mo for females. Significant independent predictors of a shorter gastric cancer-specific survival include tumor stage IV (HR 8.4 95% CI 2.0–35.0, P < 0.003), female gender (HR 2.3 95% CI 1.0–4.9, P < 0.02). Conclusion Increased incidence of cardia/fundus tumors and stage IV disease may contribute to the sustained higher gastric cancer-specific mortality observed amongst black patients. Female gender emerged as an independent predictor of a shorter survival time.
ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2009.03.097