(ChemotherapyAdvisor) – Those who survive gastric and gastroesophageal junction (GEJ) adenocarcinoma more than 3 years following diagnosis “have demographic and pathologic characteristics distinct from those who do not survive,” with Asian race an independent predictor of survival, results of a California population-based study reported in the Journal of Clinical Oncology online September 4.
“In the United States, gastric cancer is rapidly fatal with a 25% 5-year survival,” Pamela L. Kunz, MD, Stanford University School of Medicine, Stanford Cancer Center, Stanford, CA, and colleagues noted. “Of the few patients who survive, little is known about their demographic, clinical, and tumor characteristics.”
The investigators obtained data on 47,647 patients in the California Cancer Registry diagnosed with gastric and GEJ cancer between 1988 and 2005.
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“Of those, only 9,325 (20%) survived at least 3 years,” they found. “Earlier stage, surgery, chemotherapy, intestinal histology, well- or moderately differentiated tumors, radiation, Asian race, treatment at an academic hospital, fundus/body/antrum anatomic location, higher SES, female sex, Hispanic race, and hospital size of more than 150 beds were the strongest independent predictors of survival,” they wrote.
Longer median disease-specific survival (DSS) was observed among patients with tumors originating in the fundus/body/antrum (13.4 months) vs esophagus/cardia (10.8 months). Significantly longer median DSS was also found with intestinal histology (28.9 months) vs other (11.0 months) or diffuse (10.1 months) histology.
“The most provocative finding is that Asian race serves as an independent predictor of gastric cancer survival,” Dr. Kunz reported. “Given that the state of California has a relatively high proportion of Asian residents compared with other regions in the United States, the California Cancer Registry is an ideal resource for further studies of Asian patients with gastric cancer. In particular, case-control studies would allow us to collect more detailed information about cancer stage, chemotherapy, and environmental risk factors in addition to tissue and blood data for survivors of gastric cancer.
