title: Long-term survivors of gastric cancer: a California population-based study.
abstract: OBJECTIVE
  In the United States, gastric cancer is rapidly fatal with a 25% 5-year survival. Of the few patients who survive, little is known about their demographic, clinical, and tumor characteristics.
  
  
  METHODS
  Data regarding all cases of gastric and gastroesophageal junction (GEJ) adenocarcinoma diagnosed in California between 1988 and 2005 were obtained from the California Cancer Registry, a member of the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program. A Cox proportional hazards model was constructed to understand the independent relationships of patient demographic, disease, and treatment factors with survival.
  
  
  RESULTS
  We identified 47,647 patients diagnosed with gastric or GEJ cancer. Of those, only 9,325 (20%) survived at least 3 years. Variables associated with longer survival were localized stage (hazard ratio [HR], 0.20), surgery with diagnosis in 2002 or later (HR, 0.34), surgery with diagnosis in 2001 or before (0.37), regional stage (HR, 0.53), chemotherapy (HR, 0.56), intestinal histology (HR, 0.74), well- or moderately differentiated tumors (HR, 0.76), radiation (HR, 0.80), Asian/Pacific Islander race (HR, 0.81), treatment at an academic hospital (HR, 0.85), fundus/body/antrum location (HR, 0.90), highest socioeconomic status quintile (HR, 0.91), female sex (HR, 0.92), Hispanic race (HR, 0.92), and hospital size more than 150 beds (HR, 0.94). Kaplan-Meier curves showed longer median disease-specific survival (DSS) in patients with tumors originating in the fundus/body/antrum compared with esophagus/cardia (13.4 v 10.8 months). Intestinal histology had significantly longer median DSS (28.9 months) compared with other (11.0 months) or diffuse (10.1 months) histology.
  
  
  CONCLUSIONS
  Patients who survive gastric and GEJ cancer more than 3 years after diagnosis have demographic and pathologic characteristics distinct from those who do not survive.
authors.affiliation: Stanford University School of Medicine, Stanford Cancer Center, 875 Blake Wilbur Dr, Stanford, CA 94025-5826, USA. pkunz@stanford.edu
authors.forename: Pamela L
authors.initials: PL
authors.lastname: Kunz
authors.forename: Matthew
authors.initials: M
authors.lastname: Gubens
authors.forename: George A
authors.initials: GA
authors.lastname: Fisher
authors.forename: James M
authors.initials: JM
authors.lastname: Ford
authors.forename: Daphne Y
authors.initials: DY
authors.lastname: Lichtensztajn
authors.forename: Christina A
authors.initials: CA
authors.lastname: Clarke
mesh_terms: D000230:Adenocarcinoma / Q000208:ethnology / Q000401:mortality* / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D002140:California / Q000453:epidemiology; D006630:Hispanic or Latino; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D044468:Native Hawaiian or Pacific Islander; D013274:Stomach Neoplasms / Q000208:ethnology / Q000401:mortality* / Q000473:pathology; D017741:Survivors; D044465:White People