Abstract
Objectives
To evaluate gender differences in initial presentation, pathology and outcomes with GC (GC).
Methods
The 1973–2013 Surveillance Epidemiology and End Results (SEER) 17-registry database was analysed for renal tumours from 1973 to 2013 coded as primary site “stomach”. After various exclusions, a final study group of 99,922 cases with complete data was obtained. Demographic variables analysed included age, sex, marital status and race. Tumour variables included size, stage at diagnosis, grade, primary site, treatment and histology. Primary outcome variables included overall survival (OS) and cancer-specific survival (CSS).
Results
Overall, 96,501 gastric cancer patients were identified. Of those, 34,862 (36.2%) were women. For woman, log-rank test showed that OS and CSS were significantly longer in man (p < 0.0001). In Cox regression analysis, woman was associated with a significantly improved OS [(HR of death in 1973 to 2003 = 0.87, 95% CI = 0.85–0.89, P < 0.001) (HR of death in 2004 to 2013 = 0.94, 95% CI = 0.91–0.97, P < 0.001)] and cancer-specific survival [(HR of death in 1973 to 2003 = 0.90, 95% CI = 0.87–0.92, P < 0.001) (HR of death in 2004 to 2013 = 0.90, 95% CI = 0.87–0.93, P < 0.001)]. When performing a Kaplan-Meier curve analysis after propensity score matching, gender persisted to be a significant survival of woman for OS and CSS.
Conclusions
Men present with larger, higher stage, higher grade GC than women. OS and CSS are better in women, which is significantly different.
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CZ and HL conceived and designed the study. ZW, CW, WC and YH performed the statistical analysis. HL and ZW wrote the paper. All authors read and approved the manuscript.
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Huafu Li and Zhewei Wei are joint first authors.
Electronic Supplementary Material
ESM 1
Univariate Cox Analyses of GC Patients According to Various Clinicopathological Variables. A and B, Analyses of OS in 1973–2003 and 2004–2013. C and D, Analyses of CSS in 1973–2003 and 2004–2013. (ZIP 8.89 mb)
ESM 2
Multivariate Cox Analyses of GC Patients According to Various Clinicopathological Variables. A and B, Analyses of OS in 1973–2003 and 2004–2013. C and D, Analyses of CSS in 1973–2003 and 2004–2013. (ZIP 7.33 mb)
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Li, H., Wei, Z., Wang, C. et al. Gender Differences in Gastric Cancer Survival: 99,922 Cases Based on the SEER Database. J Gastrointest Surg 24, 1747–1757 (2020). https://doi.org/10.1007/s11605-019-04304-y
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DOI: https://doi.org/10.1007/s11605-019-04304-y