title: Asian gastric cancer patients show superior survival: the experiences of a single Australian center.
abstract: BACKGROUND
  Survival after curative gastrectomy for gastric cancer varies depending on region. The 5-year survival rates in Western trials reach 36-47% compared with 40-60% in Japanese studies. We analyzed the outcomes of Asian and non-Asian patients at a single Australian institution.
  
  
  METHODS
  We analyzed a prospectively kept database of patients following gastric resection between 1994 and 2010 at a tertiary Australian hospital. Overall survival was the primary endpoint.
  
  
  RESULTS
  A total of 160 patients underwent a R0 gastrectomy with curative intent, of whom 26 (16%) were of Asian descent. Asian patients had a significantly younger age at diagnosis (60 ± 16 vs. 70 ± 11, p < 0.05) and longer overall survival (log-rank p = 0.018). Poor prognostic factors common to both groups included increased tumor length, higher T-score, higher LN ratio, poor tumor differentiation, and the presence of perineural or perivascular invasion. Multivariate analysis showed that non-Asian patients, higher T-score, higher N-score, and perivascular involvement were all independent predictors of poorer outcome.
  
  
  CONCLUSIONS
  This study shows superior overall survival in Asian patients despite similar clinicopathological and treatment data. The younger age at diagnosis in Asian patients may suggest a different disease process between ethnicities. Targeted therapies based on population-specific tumor biology may potentially be beneficial.
authors.affiliation: Department of Upper GI Surgery, Bankstown Hospital, Bankstown, Sydney, NSW, Australia, yufeichen@gmail.com.
authors.forename: Yufei
authors.initials: Y
authors.lastname: Chen
authors.forename: Jan Willem
authors.initials: JW
authors.lastname: Haveman
authors.forename: Christos
authors.initials: C
authors.lastname: Apostolou
authors.forename: David K
authors.initials: DK
authors.lastname: Chang
authors.forename: Neil D
authors.initials: ND
authors.lastname: Merrett
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000706:statistics & numerical data*; D001315:Australia; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D015996:Survival Rate; D044465:White People / Q000706:statistics & numerical data*