Trends in Clinicopathologic Characteristics and Prognostic Predictors of Survival Outcome in Black Patients with Gastric Carcinoma: A Single Institution's Experience

BackgroundAge, gender, and ethnic group-related differences influence the outcome of gastric cancer. Our aim was to analyze the trends and association of clinicopathologic characteristics and prognostic factors of gastric cancer in black patients over a period of 28 y.MethodsA retrospective analysis of all black patients treated for gastric cancer from 1979 to 2007 at Howard University Teaching Hospital. This period was divided into two time frames, 1979–1993 and 1994–2007.ResultsOf 286 patients in our study, there were 160 (55.9%) males versus 126 (44.1%) females. For the period 1979–1993, there were a total of 169 (59.1%) patients versus 117 (40.9%) for 1994–2007. A significant increase in the incidence of cardia/fundus tumors and stage IV tumors was noted between the two periods (P < 0.02, P < 0.004), 8.9% versus 12% and 71.4% versus 50.8%. The median survival time for the period 1979–1993 was 30.5 mo versus 39.2 mo for 1994–2007. The median survival time for males was 35.7 mo versus 34.9 mo for females. Significant independent predictors of a shorter gastric cancer-specific survival include tumor stage IV (HR 8.4 95% CI 2.0–35.0, P < 0.003), female gender (HR 2.3 95% CI 1.0–4.9, P < 0.02).ConclusionIncreased incidence of cardia/fundus tumors and stage IV disease may contribute to the sustained higher gastric cancer-specific mortality observed amongst black patients. Female gender emerged as an independent predictor of a shorter survival time.