Presentation, Treatment, and Survival Among Asians With Gastric Cancer.

INTRODUCTION

In aggregate, Asian patients have a higher incidence and mortality from gastric cancer (GC) than Non-Hispanic White (NHW) patients. However, there is a lack of data regarding outcomes among Asian-American subpopulations with GC.

METHODS

The National Cancer Database was used to identify patients with GC between 2004 and 2020. Asian patients were disaggregated by region, with a further subanalysis of Eastern Asians. Outcomes of interest included the initial localized/regional presentation versus metastatic disease and cancer care measures including undergoing surgical excision or resection for stages I-III, receiving guideline-concordant care, receiving delayed treatment (> 90 days for any treatment type), and overall survival. Outcomes were adjusted for patient/disease characteristics, treatment, and zip-code socioeconomic factors using logistic regression.

RESULTS

Among 182,811 patients with GC, 7.2% (n = 13,051) were classified as Asian. More than one-half of the Asian cohort was categorized as East Asian (n = 6,762, 50.1%), with Chinese patients compromising 44.0% (n = 2972) of this subcohort. East Asian patients had greater odds of presenting with nonmetastatic disease (odds ratio [OR] 1.59; P < 0.001), undergoing a curative-intent resection (OR 1.52; P < 0.001), and receiving guideline-concordant care (OR 1.26; P < 0.001) compared to NHW patients. Asians from outside of East, Southeast, and South Asia had increased odds of delayed treatment (OR 1.29, P = 0.024). Asians, in aggregate and by each subpopulation, had a lower mortality risk than NHW patients (P < 0.001).

CONCLUSIONS

Asian patients with GC have improved outcomes in aggregate compared to NHW patients, largely driven by the East Asian subpopulation. All Asian subpopulations demonstrated improved survival in comparison with NHW patients.