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1.
J Gastrointest Surg ; 19(2): 251-7, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25421357

RESUMO

INTRODUCTION: In prior analyses, conditional survival (CS) estimates for gastric cancer have weighed clinical and pathologic factors to predict prognosis at time intervals after surgery. Since racial disparities in gastric cancer outcomes were not considered, our objective was to determine whether race influences CS estimates. METHODS: Data from the Surveillance, Epidemiology, and End Results cancer registry were used to identify gastric adenocarcinoma patients who underwent curative surgical intervention between 1988 and 2005. Five-year relative conditional survival (RCS) was computed for patients who survived at least 1 to 5 years after surgery. RCS was calculated by assessing observed and expected survival in an age- and race-matched standard population. Results were compared across time and racial groups (white, black, and Asian) using z test statistics. RESULTS: Of 14,067 patients, 63.8 % were white, 15.5 % black, and 20.7 % Asian. Racial disparities among groups were observed with improved survival of Asians at time point zero and improved RCS at 1 year. At 5 years following curative surgery, each racial group had increased RCS and the greatest magnitude of relative increase was observed in white and black patients (121 and 118 %, respectively). Comparison of RCS at the 5-year time point revealed a reduction of racial disparities in survival among the three groups. CONCLUSIONS: Our investigation shows that racial disparities in gastric cancer outcomes are pronounced at the time of curative surgery but diminish after years of survival, thus suggesting race has less influence over outcomes the longer patients survive. The reasons for reduction of racial disparities remain unclear and warrant future study.


Assuntos
Adenocarcinoma/etnologia , Adenocarcinoma/mortalidade , Disparidades nos Níveis de Saúde , Grupos Raciais/estatística & dados numéricos , Neoplasias Gástricas/etnologia , Neoplasias Gástricas/mortalidade , Adenocarcinoma/cirurgia , Adulto , Idoso , Povo Asiático/estatística & dados numéricos , População Negra/estatística & dados numéricos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Programa de SEER , Neoplasias Gástricas/cirurgia , Taxa de Sobrevida , Fatores de Tempo , Estados Unidos/epidemiologia , População Branca/estatística & dados numéricos , Adulto Jovem
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