Asian gastric cancer patients show superior survival: the experiences of a single Australian center

Background: Survival after curative gastrectomy for gastric cancer varies depending on region. The 5-year survival rates in Western trials reach 36–47 % compared with 40–60 % in Japanese studies. We analyzed the outcomes of Asian and non-Asian patients at a single Australian institution.Methods: We analyzed a prospectively kept database of patients following gastric resection between 1994 and 2010 at a tertiary Australian hospital. Overall survival was the primary endpoint.Results: A total of 160 patients underwent a R0 gastrectomy with curative intent, of whom 26 (16 %) were of Asian descent. Asian patients had a significantly younger age at diagnosis (60 ± 16 vs. 70 ± 11, p < 0.05) and longer overall survival (log-rank p = 0.018). Poor prognostic factors common to both groups included increased tumor length, higher T-score, higher LN ratio, poor tumor differentiation, and the presence of perineural or perivascular invasion. Multivariate analysis showed that non-Asian patients, higher T-score, higher N-score, and perivascular involvement were all independent predictors of poorer outcome.Conclusions: This study shows superior overall survival in Asian patients despite similar clinicopathological and treatment data. The younger age at diagnosis in Asian patients may suggest a different disease process between ethnicities. Targeted therapies based on population-specific tumor biology may potentially be beneficial.