Overall Survival Is Impacted by Birthplace and Not Extent of Surgery in Asian Americans with Resectable Gastric Cancer
Overall Survival Is Impacted by Birthplace and Not Extent of Surgery in Asian Americans with Resectable Gastric Cancer
复制标题
DOI：
10.1007/s11605-015-2919-8
复制
发表时间：
2015-11-01
影响因子：
3.2
通讯作者：
Bilchik, Anton J.
中科院分区：
文献类型：
--
作者：
Kirchoff, Daniel D.;Deutsch, Gary B.;Bilchik, Anton J.
美国的胃癌存活率仍然落后于亚洲。遗传、环境和肿瘤生物学差异以及手术范围都与此有关。我们的目的是通过比较出生地点和临床病理特征(包括15个淋巴结的评估)来评估接受手术切除的亚裔美国人胃癌患者的生存结果。查询美国的监测、流行病学和最终结果数据库以确定有治疗意图的胃癌手术患者(2000-2010)。对在美国出生的亚裔美国患者和在外国出生的亚裔美国患者进行了生存分析。与非亚洲患者进行二次比较。排除IV期患者和非手术患者。在确认的10,089名患者中，有1467名患者是亚洲人：271名出生在美国，1196名出生在美国以外。非亚洲人的中位生存期为32个月，在美国出生的亚洲人为29个月，而亚洲移民为61个月(p<；0.001)。在对亚洲患者总体生存率的多变量分析中，只有美国出生地、年龄较大和分期较高的患者的预后明显较差。如果出生在美国，亚裔美国人的预后更差。解剖学和外科手术的差异不能解释这种差异；环境因素可能是原因。
Survival from gastric cancer in the USA still lags behind Asia. Genetic, environmental, and tumor biology differences, along with extent of surgery have been implicated. Our aim was to evaluate survival outcomes in Asian-American gastric cancer patients undergoing surgical resection by comparing place of birth and clinicopathologic characteristics (including evaluation of 15 lymph nodes).The Surveillance, Epidemiology, and End Results database was queried to identify patients treated surgically for gastric cancer with curative intent in the USA (2000-2010). US-born versus foreign-born Asian-American patients were analyzed for survival. Secondary comparison was made to non-Asian patients. Stage IV and non-surgical patients were excluded. Of 10,089 patients identified, 1467 patients were Asian: 271 were born in the USA, and 1196 were born outside the USA. Median survival was 32 months for non-Asians and 29 months for US-born Asians versus 61 months for Asian immigrants (p < 0.001). On multivariable analysis of overall survival in Asian patients, only US birthplace, older age, and higher stage yielded a significantly poorer outcome. Asian-American patients have a worse prognosis if born in the USA. Anatomic and surgical differences do not explain this disparity; environmental factors may be responsible.