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Comparative Study
. 2018 Nov;118(6):975-982.
doi: 10.1002/jso.25220. Epub 2018 Oct 17.

Comparison of gastric cancer survival after R0 resection in the US and China

Ping Li  1 , Chang-Ming Huang  1 , Chao-Hui Zheng  1 , Ashley Russo  2 , Priyanka Kasbekar  2 , Murray F Brennan  2 , Daniel G Coit  2 , Vivian E Strong  2
Affiliations
Comparative Study

Comparison of gastric cancer survival after R0 resection in the US and China

Ping Li et al. J Surg Oncol. 2018 Nov.

Abstract

Background and objectives: Gastric cancer (GC) outcomes differ between Asian and Western countries, even when controlling for contributing factors, but whether this difference holds true for China remains inadequately studied. We sought to compare the presentation, treatment, and outcomes of patients with GC undergoing curative intent (R0) resection between the US and China, and to ascertain whether geography/ institution is an independent predictor of disease-specific survival (DSS).

Methods: Data were analyzed from patients with GC undergoing R0 resection at high-volume cancer centers in the US (Memorial Sloan Kettering Cancer Center [MSKCC], n = 1378) and China (Fujian Medical University Union Hospital [FMUUH], n = 4262) between 2000 and 2014. Factors associated with DSS were examined by multivariate analysis.

Results: The 5-year DSS ( P < 0.001) for all patients was better at MSKCC than at FMUUH, even among patients not receiving preoperative chemotherapy ( P < 0.001), but stratification by substage eliminated this difference ( P > 0.05). Factors independently associated with DSS included age, histology, tumor size, T category, N category, gastrectomy type, and preoperative chemotherapy, but not institution.

Conclusions: Although the presentation of patients with GC between MSKCC and FMUUH differs, survival of patients with curatively resected GC, when matched for clinical stage, is comparable.

Keywords: China; Eastern and Western; United States; perioperative chemotherapy; prognosis; stomach cancer; stomach neoplasms.

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Figures

Figure 1.
Figure 1.
Disease-specific survival of all patients.
Figure 2.
Figure 2.
Comparison of disease-specific survival in patients in patients receiving surgery without preoperative chemotherapy between MSKCC and FMUUH. a, all stages; b, stage I; c, stage II; d, stage III.
See this image and copyright information in PMC

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