Factors associated with high mortality of gastric adenocarcinoma in Thailand versus Japan

Rapat Pittayanon, Noriya Uedo, Thapaee Praipisut, Yusuke Tounai, Rungsun Rerknimitr, Pinit Kullavanijaya

Abstract


Background and aim: Thailand and Japan have high prevalence of Helicobacter pylori infection but prevalence of gastric cancer and mortality rate are difference. Most international comparative studies are epidemiologic studies and the difference in actual clinicopathological data has not been clarified. This study aimed to investigate the difference in clinicopathological characteristics of gastric adenocarcinoma between Thailand and Japan.

Methods: This retrospective study was conducted in two high-volume hospitals for gastric cancer in Thailand and Japan. Baseline characteristics, clinical manifestations, tumor characteristics, treatments and mortality rate of gastric cancer patients in the two institutions were examined.

Results: A total of 403 Thai and 2,318 Japanese patients were retrieved from the electronic database. Finally, 332 Thai and 414 Japanese patients (randomly sampled) with gastric adenocarcinoma were eligible for analysis. Thai gastric adenocarcinoma patients were significantly younger than the Japanese (59 ± 13 vs. 68 ±10 years old, p<0.001) and the majority of Thai patients were female (55% vs. 25%, p<0.001). The rate of smoking (5.1% vs. 23%, p<0.001) and alcohol drinking (2.7% vs. 34%, p<0.001) were lower in Thai patients when compared with those in Japanese. The mortality rate at the conclusion of this study (July 2016) was significantly higher in Thai patients (75.3% vs. 7%, p<0.001). In multivariate analysis, ethnicity, clinical UICC stage II-IV compared to I, and resection-based treatment were significant prognostic factors after adjusting for age, gender, presence of alarm symptom, lesion extension and histology.

Conclusion: Thai patients with gastric adenocarcinoma were different from Japanese patients in all aspects. Advanced stage of disease, country, and un-resected tumor were associated with poor prognosis. An individual strategy to improve survival of gastric adenocarcinoma in a low-prevalence area such as Thailand should be explored.


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References


Allemani C, Weir HK, Carreira H, et al (2015). Global surveillance of cancer survival 1995-2009: analysis of individual data for 25,676,887 patients from 279 population-based registries in 67 countries (CONCORD-2). Lancet, 385, 977-1010.

Asaka M (2013). A new approach for elimination of gastric cancer deaths in Japan. Int J Cancer, 132, 1272-6.

Cho JH, Cha SW, Kim HG, et al (2016). Long-term outcomes of endoscopic submucosal dissection for early gastric cancer: a comparison study to surgery using propensity score-matched analysis. Surg Endosc, 30, 3762-73.

Derose KP, Escarce JJ,Lurie N (2007). Immigrants and health care: sources of vulnerability. Health Aff (Millwood), 26, 1258-68.

Dong E, Duan L,Wu BU (2016). Racial and Ethnic Minorities at Increased Risk for Gastric Cancer in a Regional US Population Study. Clin Gastroenterol Hepatol. 15, 511-17.

Duma N, Sanchez LJ, Castro YS, et al (2016). Gastric adenocarcinoma: clinicopathologic differences among Hispanics and non-Hispanic whites. A single Institution's experience over 14 years. Ann Gastroenterol, 29, 325-31.

Ferlay J, Soerjomataram I, Dikshit R, et al (2015). Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer, 136, E359-86.

Graziosi L, Marino E, Cavazzoni E, et al (2013). Prognostic value of the seventh AJCC/UICC TNM classification of non-cardia gastric cancer. World J Surg Oncol, 11, 103.

Hamashima C, Ogoshi K, Narisawa R, et al (2015). Impact of endoscopic screening on mortality reduction from gastric cancer. World J Gastroenterol, 21, 2460-6.

Isobe Y, Nashimoto A, Akazawa K, et al (2011). Gastric cancer treatment in Japan: 2008 annual report of the JGCA nationwide registry. Gastric Cancer, 14, 301-16.

Japanese Gastric Cancer Association (2011). Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer, 14, 101-12.

Koizumi W, Narahara H, Hara T, et al (2008). S-1 plus cisplatin versus S-1 alone for first-line treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol, 9, 215-21.

Lauwers GY, Carneiro F,Graham DY (2010). Gastric carcinoma. In 'Classification of Tumours of the Digestive System', Eds Bowman FT, Carneiro F and Hruban RH. IARC, Lyon

Malaty HM, Engstrand L, Pedersen NL, et al (1994). Helicobacter pylori infection: genetic and environmental influences. A study of twins. Ann Intern Med, 120, 982-6.

Nanthanangkul S, Suwanrungruang K, Wiangnon S, et al (2016). Survival of Stomach Cancer Cases in Khon Kaen, Thailand 2000-2012. Asian Pac J Cancer Prev, 17, 2125-9.

Nardone G, Staibano S, Rocco A, et al (1999). Effect of Helicobacter pylori infection and its eradication on cell proliferation, DNA status, and oncogene expression in patients with chronic gastritis. Gut, 44, 789-99.

National Cancer Institue. (2002): Stomach (Gastric) Cancer Prevention (PDQ(R)): Health Professional Version. Bethesda. http://www.ncbi.nlm.nih.gov/pubmed/26389263.

Naylor GM, Gotoda T, Dixon M, et al (2006). Why does Japan have a high incidence of gastric cancer? Comparison of gastritis between UK and Japanese patients. Gut, 55, 1545-52.

Ryu SJ, Kim BW, Kim BG, et al (2016). Endoscopic submucosal dissection versus surgical resection for early gastric cancer: a retrospective multicenter study on immediate and long-term outcome over 5 years. Surg Endosc, 30, 5283-9.

Sahara S, Sugimoto M, Vilaichone RK, et al (2012). Role of Helicobacter pylori cagA EPIYA motif and vacA genotypes for the development of gastrointestinal diseases in Southeast Asian countries: a meta-analysis. BMC Infect Dis, 12, 223.

Sobin LH, Gospodarowicz MK,Wittekind CH e (2009). In 'International Union Against Cancer (UICC) TNM Classification of Malignant Tumors. 7ed.', Eds Sobin LH, Gospodarowicz MK and CH W. Wiley-Blackwell, Oxford

Suzuki H, Gotoda T, Sasako M, et al (2006). Detection of early gastric cancer: misunderstanding the role of mass screening. Gastric Cancer, 9, 315-9.

Tan YK,Fielding JW (2006). Early diagnosis of early gastric cancer. Eur J Gastroenterol Hepatol, 18, 821-9.

Thompson CA, Gomez SL, Hastings KG, et al (2016). The Burden of Cancer in Asian Americans: A Report of National Mortality Trends by Asian Ethnicity. Cancer Epidemiol Biomarkers Prev, 25, 1371-82.

Torre LA, Bray F, Siegel RL, et al (2015). Global cancer statistics, 2012. CA Cancer J Clin, 65, 87-108.

Trinh QD, Nguyen PL, Leow JJ, et al (2015). Cancer-specific mortality of Asian Americans diagnosed with cancer: a nationwide population-based assessment. J Natl Cancer Inst, 107, djv054.

Uchida T, Miftahussurur M, Pittayanon R, et al (2015). Helicobacter pylori Infection in Thailand: A Nationwide Study of the CagA Phenotype. PLoS One, 10, e0136775.

Waters JS, Norman A, Cunningham D, et al (1999). Long-term survival after epirubicin, cisplatin and fluorouracil for gastric cancer: results of a randomized trial. Br J Cancer, 80, 269-72.

Yao JC, Tseng JF, Worah S, et al (2005). Clinicopathologic behavior of gastric adenocarcinoma in Hispanic patients: analysis of a single institution's experience over 15 years. J Clin Oncol, 23, 3094-103.




DOI (PDF (FULL TEXT)): http://dx.doi.org/10.22034/APJCC.2018.3.2.9

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