Evaluation of treatment and outcomes for Hispanic patients with gastric cancer at Commission on Cancer-accredited centers in the United States.

BACKGROUND AND OBJECTIVES

Gastric cancer in the Hispanic population commonly presents with poor clinical features. Characteristics of this vulnerable population and optimal therapy for these patients have not been clearly defined.

METHODS

Using the National Cancer Database (2004-2014), we analyzed patient demographics, clinical factors, treatment-related factors, and outcomes for Hispanic and non-Hispanic patients with gastric adenocarcinoma in the United States.

RESULTS

A total of 129 666 patients were included in this analysis. Hispanics were younger, more often female, had larger tumors, and were more likely to present with metastatic disease (all P < 0.001). Hispanics were more likely to undergo staging laparoscopy (5.6% vs 4.9%; P = 0.037), gastrectomy (63.5% vs 56.9%; P < 0.001), and ≥ 15 lymph nodes examined (56.1% vs 50.5%; P < 0.001). Hispanics were less likely to have negative margins (91.2% vs 92.8%; P = 0.004). Hispanics with stage II/III disease were less likely to receive neoadjuvant therapy (31.7% vs 38.7%; P < 0.001), but more likely to receive multimodal therapy (48.9% vs 46.1%; P = 0.01). Predictors for improved overall survival in Hispanics included multimodal therapy, negative margins, and treatment at an academic center.

CONCLUSIONS

Efforts to optimize treatment of this distinct and growing population of gastric cancer patients should focus on earlier diagnosis, referral to academic centers, and high-quality surgery.