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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2008

01-06-2008 | Gastrointestinal Oncology

Differences in the Pattern of Presentation and Treatment of Proximal and Distal Gastric Cancer: Results of the 2001 Gastric Patient Care Evaluation

Authors: Neal W. Wilkinson, MD, MPH, James Howe, MD, Greer Gay, PhD, MPH, Lina Patel-Parekh, MHA, Carol Scott-Conner, MD, PhD, John Donohue, MD

Published in: Annals of Surgical Oncology | Issue 6/2008

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Abstract

Background

While the overall incidence of gastric cancer has declined in the United States of America, the incidence of proximal gastric cancers has increased. The purpose of this analysis was to highlight key differences between proximal and distal gastric cancer as they relate to presentation and treatment.

Methods

Data on 6,099 patients diagnosed with gastric adenocarcinoma were collected as a patient care evaluation under the auspices of the American College of Surgeons Commission on Cancer. The chi-square (χ 2) test was used for comparisons of proportions across levels of categorical variables by site.

Results

The proximal cancer group included 1,924 patients (87% cardia, 13% fundus) and the distal cancer group included 1,311 patients (85% antrum, 15% pylorus). Proportionately, proximal cancer cases were male (P < 0.01), younger (P < 0.01), and White (P < 0.01); whereas, distal gastric cancer cases were Black (P < 0.01), Hispanic (P < 0.01), and Asian (P = 0.01). Surgery alone (without adjuvant chemotherapy or radiation) was utilized more frequently in distal disease (39.5%) compared to proximal disease (25.7%) (P < 0.01). Preoperative adjuvant therapy was utilized more frequently in proximal disease (41.7%) compared to distal disease (2.1%) (P < 0.01).

Conclusions

The populations that developed proximal verses distal gastric cancer differed with respect to sex, age, and racial background. Cancer-directed treatments also differed based upon tumor location. Understanding these differences may someday enable us to identify important high-risk populations, prevention strategies, and ultimately best treatment strategies. Long-term survival differences will be explored when follow-up data become available.
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Metadata
Title
Differences in the Pattern of Presentation and Treatment of Proximal and Distal Gastric Cancer: Results of the 2001 Gastric Patient Care Evaluation
Authors
Neal W. Wilkinson, MD, MPH
James Howe, MD
Greer Gay, PhD, MPH
Lina Patel-Parekh, MHA
Carol Scott-Conner, MD, PhD
John Donohue, MD
Publication date
01-06-2008
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 6/2008
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-008-9877-2

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