Preoperative Treatment for Gastric Cancer Varies by Race, Ethnicity

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The association between the use of preoperative chemotherapy for patients with gastric cancer and race has not been extensively researched.
The association between the use of preoperative chemotherapy for patients with gastric cancer and race has not been extensively researched.

Differences in preoperative chemotherapy use and outcomes for patients with gastric cancer in the United States may be explained by patients' race and/or ethnicity, according to evidence from a study published in Cancer.

The incidence of preoperative chemotherapy for patients with gastric cancer has increased sharply over the past decade, but the association between its use and race and/or ethnicity has not been explored.

For this retrospective cohort study, investigators analyzed the outcomes data of 16,945 patients with gastric carcinoma diagnosed between 2006 and 2014 by accessing the National Cancer Data Base (NCDB), of whom 8286 patients had received preoperative chemotherapy. Multiple logistic regressions were used to examine the associations between preoperative chemotherapy and various factors, adjusting for variables such as age, race, ethnicity, year of treatment, and hospital type.

Results of the study showed that the incidence of preoperative chemotherapy increased drastically over the course of the study, from 34% in 2006 to 65% in 2014, and preoperative chemotherapy was used more frequently for cardia vs noncardia tumors.

Multivariate analyses once adjusted for social, tumor, and hospital factors, revealed that groups other than non-Hispanic (NH) whites received preoperative chemotherapy less frequently compared with NH white patients. No insurance and low education status — observed more frequently among persons who were not NH white — were also factors associated with less preoperative chemotherapy.

A review of survival outcomes revealed no differences in overall survival between patients from different racial and ethnic groups who received preoperative chemoradiation.

The authors concluded that "efforts to improve the access to high-quality cancer care in minority groups may reduce racial disparities in gastric cancer in the United States.”

Reference

Ikoma N, Cormier JN, Feig B, et al. Racial disparities in preoperative chemotherapy use in gastric cancer patients in the United States: analyses of the National Cancer Data Base, 2006-2014 [published online February 2, 2018]. Cancer. doi: 10.1002/cncr.31155
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