Abdel-Rahman Omar
Department of Oncology, University of Alberta and Cross Cancer Institute, Edmonton, Alberta, Canada.
World J Gastrointest Oncol. 2019 Dec 15;11(12):1151-1160. doi: 10.4251/wjgo.v11.i12.1151.
It has been recognized for a long time that gastric cancer behavior and outcomes might be different between patients living in Asian countries patients living in Western countries. It is not clear if these differences would persist between patients of Asian ancestry and patients of other racial subgroups within the multiethnic communities of North America. The current study hypothesizes that these differences will present within North American multiethnic communities.
To evaluate the impact of race on survival outcomes of non-metastatic gastric cancer patients in the United States.
This is a secondary analysis of a randomized controlled trial (CALGB 80101 study) that evaluated two adjuvant chemoradiotherapy schedules following resection of non-metastatic gastric cancer. Kaplan-Meier analysis and log-rank testing were utilized to explore the overall and disease-free survival differences according to the race of the patients. Univariate and multivariate Cox regression analyses were then used to explore factors affecting overall and disease-free survivals.
A total of 546 patients were included in the current analysis. Of which, 73.8% have white race ( 12.8% black Americans and 8.2% Asian Americans). Using Kaplan-Meier analysis/log-rank testing, Asian Americans appear to have better overall and disease-free survival outcomes compared to other United States racial groups (White Americans, Black Americans, and other racial groups) ( = 0.011; = 0.010; respectively). Moreover, in an adjusted multivariate model, Asian American race seems to be associated with better overall and disease-free survival (hazard ratio: 0.438; 95% confidence interval: 0.254-0.754), = 0.003; hazard ratio: 0.460; 95% confidence interval: 0.280-0.755, = 0.002; respectively).
Asian American patients with non-metastatic gastric cancer have better overall and disease-free survival compared to other racial groups in the United States. Further preclinical and clinical research is needed to clarify the reasons behind this observation.
长期以来人们认识到，亚洲国家的胃癌患者与西方国家的胃癌患者在行为和预后方面可能存在差异。目前尚不清楚在北美多民族社区中，亚洲血统患者与其他种族亚组患者之间这些差异是否仍然存在。当前研究假设这些差异将在北美多民族社区中出现。
评估种族对美国非转移性胃癌患者生存结局的影响。
这是一项对随机对照试验（CALGB 80101研究）的二次分析，该试验评估了非转移性胃癌切除术后的两种辅助放化疗方案。采用Kaplan-Meier分析和对数秩检验，根据患者种族探讨总生存和无病生存差异。然后使用单因素和多因素Cox回归分析探讨影响总生存和无病生存的因素。
本分析共纳入546例患者。其中，73.8%为白人（非裔美国人占12.8%，亚裔美国人占8.2%）。使用Kaplan-Meier分析/对数秩检验，与美国其他种族群体（美国白人、非裔美国人及其他种族群体）相比，亚裔美国人似乎具有更好的总生存和无病生存结局（分别为P = 0.011；P = 0.010）。此外，在调整后的多因素模型中，亚裔美国人种族似乎与更好的总生存和无病生存相关（风险比：0.438；95%置信区间：0.254 - 0.754，P = 0.003；风险比：0.460；95%置信区间：0.280 - 0.755，P = 0.002；分别）。
与美国其他种族群体相比，亚裔美国非转移性胃癌患者具有更好的总生存和无病生存。需要进一步的临床前和临床研究来阐明这一观察结果背后的原因。
