title: Clinicopathologic behavior of gastric adenocarcinoma in Hispanic patients: analysis of a single institution's experience over 15 years.
abstract: OBJECTIVE
  To determine the clinicopathologic behavior of gastric adenocarcinoma in Hispanics by comparing Hispanic and non-Hispanic patients treated at a single cancer center.
  
  
  METHODS
  Medical records of patients with invasive gastric cancer treated from 1985 to 1999 were reviewed. Diagnoses were pathologically confirmed. Differences in categorical variables were assessed using the chi(2) test. Logistic regression was used for multivariate analyses. Median survival was estimated using the Kaplan-Meier method. Cox proportional hazards modeling was used to assess the impact of covariates.
  
  
  RESULTS
  Of 1,897 patients, 301 (15.9%) were Hispanic. Hispanics were significantly younger at diagnosis than non-Hispanic whites (53.1 +/- 14.4 years v 59.4 +/- 12.7 years, respectively; P < .005) or African Americans (57.6 +/- 15.3 years, P < .005). Hispanics were less likely to have proximal gastric cancers compared with whites (38.9% v 59.5%, respectively; P < .005). Hispanics were more likely to have mucinous/signet-ring type histology (42.5%) than whites (27.4%) and African Americans (32.5%; P < .005). Hispanics were more likely to require total gastrectomy (51%) compared with whites (38%), African Americans (38%), and Asians (36%; P = .039). Among patients with metastases at diagnosis, Hispanics were less likely to have liver metastasis than whites (30% v 44%, respectively; P = .009) but more likely to have peritoneal metastasis than whites and African Americans (54% v 41% and 47%, respectively; P = .002). In Cox analyses, Asian race, earlier stage, papillary/tubular histology, distal location, and younger age were favorable predictors of survival.
  
  
  CONCLUSIONS
  Hispanic ethnicity does not impact survival in gastric adenocarcinoma. However, histology, metastasis pattern, tumor localization, and other clinical parameters differ sufficiently to warrant further investigation into the epidemiology, pathogenesis, and molecular biology of gastric cancer in this population.
authors.affiliation: Department of Gastrointestinal Medical Oncology, Unit 426, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA. jyao@mdanderson.org
authors.forename: James C
authors.initials: JC
authors.lastname: Yao
authors.forename: Jennifer F
authors.initials: JF
authors.lastname: Tseng
authors.forename: Samidha
authors.initials: S
authors.lastname: Worah
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Hess
authors.forename: Paul F
authors.initials: PF
authors.lastname: Mansfield
authors.forename: Christopher H
authors.initials: CH
authors.lastname: Crane
authors.forename: Isac I
authors.initials: II
authors.lastname: Schnirer
authors.forename: Satish
authors.initials: S
authors.lastname: Reddy
authors.forename: Silvia S
authors.initials: SS
authors.lastname: Chiang
authors.forename: Azmeena
authors.initials: A
authors.lastname: Najam
authors.forename: Christina
authors.initials: C
authors.lastname: Yu
authors.forename: Geoffrey G
authors.initials: GG
authors.lastname: Giacco
authors.forename: Keping
authors.initials: K
authors.lastname: Xie
authors.forename: Tsung-Teh
authors.initials: TT
authors.lastname: Wu
authors.forename: Barry W
authors.initials: BW
authors.lastname: Feig
authors.forename: Peter W T
authors.initials: PW
authors.lastname: Pisters
authors.forename: Jaffer A
authors.initials: JA
authors.lastname: Ajani
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000328:Adult; D001741:Black or African American; D017668:Age of Onset; D000368:Aged; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology*; D016019:Survival Analysis; D044465:White People