title: Stage-Specific Prognostic Effect of Race in Patients with Resectable Gastric Adenocarcinoma: An 8-Institution Study of the US Gastric Cancer Collaborative.
abstract: BACKGROUND
  Gastric cancer constitutes a major public health problem. This study sought to evaluate the relevance of race in gastric cancer and its prognostic effect in the overall outcomes of patients with gastric adenocarcinoma.
  
  
  METHODS
  Patients who underwent curative intent resection of gastric adenocarcinoma in 8 institutions of the US Gastric Cancer Collaborative were included, from 2000 to 2012. Nonparametric descriptive statistics were used to evaluate characteristics of standard demographic data. Multivariate Cox proportional hazards regression was used to identify factors associated with recurrence-free survival and overall survival.
  
  
  RESULTS
  There were 1,077 patients included in the study, the majority of whom were of Caucasian race (n = 698, 68%), followed by African-American (n = 164, 15%), Asian (n = 132, 12%), Hispanic (n = 34, 3.2%), and other (n = 49, 4.5%). Clinicopathologic data were similarly distributed among the 5 groups. Mean follow-up was 27.1 months. By multivariate, stage-specific analysis, Asian race was a significant predictor of recurrence (all stages hazard ratio [HR] 0.45 95% CI [0.23, 0.97], p = 0.041) and of overall survival (all stages HR 0.35 95% CI [0.18, 0.68], p = 0.002). Recurrence-free survival was significantly increased in the Asian population compared with the non-Asian population (25th percentile: 38.6 vs 17.7 months, p = 0.0096), as was overall median survival (141 vs 38.8 months, p < 0.001).
  
  
  CONCLUSIONS
  Patients of Asian race undergoing curative gastrectomy for gastric adenocarcinoma appear to have a better prognosis stage for stage. Further studies are required to elucidate the underlying etiology of this phenomenon.
authors.affiliation: Department of Surgery, New York University, New York, NY.
authors.forename: Annie
authors.initials: A
authors.lastname: Wang
authors.affiliation: Department of Surgery, Emory University, Winship Cancer Institute, Atlanta, GA.
authors.forename: Malcolm Hart
authors.initials: MH
authors.lastname: Squires
authors.affiliation: Department of Surgery, New York University, New York, NY.
authors.forename: Marcovalerio
authors.initials: M
authors.lastname: Melis
authors.affiliation: Department of Surgery, Stanford University, Stanford Cancer Institute, Stanford, CA.
authors.forename: George A
authors.initials: GA
authors.lastname: Poultsides
authors.affiliation: Department of Surgery, Stanford University, Stanford Cancer Institute, Stanford, CA.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Norton
authors.affiliation: Department of Surgery, Barnes Jewish Hospital and The Alvin J. Siteman Cancer Center, Washington University, St. Louis, MO.
authors.forename: Linda X
authors.initials: LX
authors.lastname: Jin
authors.affiliation: Department of Surgery, Barnes Jewish Hospital and The Alvin J. Siteman Cancer Center, Washington University, St. Louis, MO.
authors.forename: Ryan C
authors.initials: RC
authors.lastname: Fields
authors.affiliation: Department of Surgery, The Johns Hopkins University, Baltimore, MD.
authors.forename: Gaya
authors.initials: G
authors.lastname: Spolverato
authors.affiliation: Department of Surgery, The Johns Hopkins University, Baltimore, MD.
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Pawlik
authors.affiliation: Department of Surgery, Wake Forest University, Winston-Salem, NC.
authors.forename: Konstantinos I
authors.initials: KI
authors.lastname: Votanopoulos
authors.affiliation: Department of Surgery, Wake Forest University, Winston-Salem, NC.
authors.forename: Edward A
authors.initials: EA
authors.lastname: Levine
authors.affiliation: Department of Surgery, The Ohio State University, Columbus, OH.
authors.forename: Carl
authors.initials: C
authors.lastname: Schmidt
authors.affiliation: Department of Surgery, The Ohio State University, Columbus, OH.
authors.forename: Mark
authors.initials: M
authors.lastname: Bloomston
authors.affiliation: Department of Surgery, University of Wisconsin, Madison, WI.
authors.forename: Clifford S
authors.initials: CS
authors.lastname: Cho
authors.affiliation: Department of Surgery, University of Wisconsin, Madison, WI.
authors.forename: Sharon
authors.initials: S
authors.lastname: Weber
authors.affiliation: Department of Surgery, New York University, New York, NY.
authors.forename: Russell
authors.initials: R
authors.lastname: Berman
authors.affiliation: Department of Surgery, New York University, New York, NY.
authors.forename: H Leon
authors.initials: HL
authors.lastname: Pachter
authors.affiliation: Department of Surgery, New York University, New York, NY.
authors.forename: Elliot
authors.initials: E
authors.lastname: Newman
authors.affiliation: Department of Surgery, Emory University, Winship Cancer Institute, Atlanta, GA.
authors.forename: Charles A
authors.initials: CA
authors.lastname: Staley
authors.affiliation: Department of Surgery, Emory University, Winship Cancer Institute, Atlanta, GA.
authors.forename: Shishir K
authors.initials: SK
authors.lastname: Maithel
authors.affiliation: Department of Surgery, New York University, New York, NY. Electronic address: Ioannis.Hatzaras@nyumc.org.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Hatzaras
mesh_terms: D000230:Adenocarcinoma / Q000208:ethnology* / Q000473:pathology* / Q000601:surgery; D000368:Aged; D018572:Disease-Free Survival; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D013274:Stomach Neoplasms / Q000208:ethnology* / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome; D014481:United States; D044465:White People / Q000706:statistics & numerical data*