title: Trends in clinicopathologic characteristics and prognostic predictors of survival outcome in black patients with gastric carcinoma: a single institution's experience.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Surgery, Howard University College of Medicine, Washington, District of Columbia 20060, USA. emeka_ihemelandu@hotmail.com
authors.forename: Chukwuemeka U
authors.initials: CU
authors.lastname: Ihemelandu
authors.forename: R L
authors.initials: RL
authors.lastname: DeWitty
authors.forename: L D
authors.initials: LD
authors.lastname: Leffall
authors.forename: M S
authors.initials: MS
authors.lastname: Suryanarayana
authors.forename: Wayne A
authors.initials: WA
authors.lastname: Frederick
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D000328:Adult; D001741:Black or African American; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D016019:Survival Analysis