Sex Disparity in Gastric Cancer: Female Sex is a Poor Prognostic Factor for Advanced Gastric Cancer
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The overall incidence of gastric cancer (GC) is higher in males than females. Specifically, signet ring cell carcinoma (SRC) is more frequently observed in younger female patients. However, limited information focused on sex-specific differences in GC has been reported. The aim of our study was to analyze clinicopathological differences between sex groups to reveal sex disparities in GC.
We retrospectively analyzed 4722 patients with GC who underwent gastrectomy (females: 1586 (33.6 %); males: 3136 (66.4 %), and analyzed clinicopathological features between these sex groups. The overall survival (OS) rate was investigated between the two sex groups, with special reference to the pathologic World Health Organization GC classifications. Immunohistochemistry staining of sex hormone receptors, including the estrogen receptor (ER)-α, ER-β, progesterone receptor, and androgen receptor, was performed according to sex and pathological classification.
Female patients were significantly associated with a younger age, poorly differentiated adenocarcinoma, and SRC compared with males. Female patients showed a significantly poorer OS than male patients, especially among those with advanced GC (AGC) aged ≤45 years. In females with AGC, those with SRC had a significantly poorer OS than those with other histologies. Moreover, the expression of ER-β was different between females and males with SRC.
Females with GC were significantly younger and had a different SRC histology compared with males. Furthermore, females had significantly poorer prognostic factors among young patients with SRC. Thus, young female GC patients with SRC are a main target group in which to improve prognosis.
KeywordsGastric Cancer Overall Survival Androgen Receptor Gastric Cancer Tissue Signet Ring Cell Carcinoma
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Hae Won Kim made substantial contributions to the conception and design of the study, analysis and interpretation of data, drafting the article, and critically revising it for important intellectual content. Jie-Hyun Kim and Beom Jin Lim made substantial contributions to the conception and design of the study, final approval of the version to be published, and agreement to be accountable for all aspects of the work. HyunKi Kim, Hoguen Kim, Jae Jun Park, Young Hoon Youn, Hyojin Park, Sung Hoon Noh, Jong Won Kim, and Seung Ho Choi critically revised the article for important intellectual content.
This study was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), and was funded by the Ministry of Education, Science and Technology (2012R1A1A1042417).
Hae Won Kim, HyunKi Kim, Hoguen Kim, Jae Jun Park, Young Hoon Youn, Hyojin Park, Sung Hoon Noh, Jong Won Kim, Seung Ho Choi, Jie-Hyun Kim and Beom Jin Lim have no disclosures to declare.
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