Outcomes in Asia

E. Strong (ed.). Gastric cancer. Principles and practice. Springer (2015)

Before discussing studies that have been performed in the West, it is important to highlight that survival rates with surgery alone in East Asia (60–70%) exceed those in the USA (40% in the Intergroup 116 study described below [11]) and even in European studies where curative extended lymph node D2 resections were performed (47% 5-year OS) [12]. Our group previously compared the single-institution experience at Memorial Sloan Kettering with that of a single Korean hospital (Seoul St. Mary’s Hospital) [13]. The Korean patients were younger, more likely to have distal tumors (while their US counterparts were more likely to have proximal tumors) and had earlier stage tumors with more lymph nodes harvested at surgery. Despite controlling for these and other known prognostic factors, the Korean patients consistently had a higher disease-specific survival (hazard ratio or HR 1.3; 95% confidence interval or CI 1.0–1.6, p = 0.008). This improved survival may suggest that there are differences in the underlying biology of East Asian gastric cancers that convey a better prognosis. As such, a comparison of outcomes in studies performed in East Asia must be done with some degree of caution.

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