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Impact of Race/Ethnicity on Prognosis in Patients Who Underwent Surgery for Colon Cancer: Analysis for White, African, and East Asian Americans

  • Colorectal Cancer
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

We retrospectively investigated the impact of race/ethnicity on prognosis in patients who underwent surgery for colon cancer.

Methods

Surveillance, Epidemiology, and End Results population-based data on 39,210 colon cancer patients without distant metastasis who underwent radical surgery were analyzed. Prognostic impact of race/ethnicity for non-Hispanic white, Hispanic white, African American, and East Asian (Japanese, Chinese, Korean) American patients, and confounding factors of age, sex, registry region, year of diagnosis, tumor, node, metastasis system stage, tumor grade, tumor site, and the number of lymph nodes examined were analyzed by the Cox proportional hazard model. The lymph node count was analyzed and adjusted means were calculated by a generalized multiple regression model with respect to race and other factors.

Results

Significant differences due to race/ethnicity were observed in crude hazard ratios with respect to overall and colon cancer-specific mortality, which persisted even after adjusting for confounding factors. Adjusted hazard ratios of colon cancer-specific mortality for non-Hispanic white, Hispanic white, African American, and East Asian American patients were 1 (reference), 1.01 (95% confidence interval 0.91–1.12), 1.40 (95% confidence interval 1.31–1.50), and 0.83 (95% confidence interval 0.74–0.94), respectively. There were significant differences in crude number of lymph nodes examined among races, which were no longer significant after adjusting for covariates.

Conclusions

East Asian American patients had significantly better prognosis, while African American patients had worse prognosis than non-Hispanic white patients, despite the identical adjusted number of lymph nodes examined after surgery for colon cancer. This disparity in prognosis among races/ethnicities should be taken into consideration when deciding adjuvant chemotherapy for nonwhite patients.

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Disclosure

There is no specific funding source for this work. There is no financial disclosure.

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Authors and Affiliations

  1. Department of Surgery, National Defense Medical College, Saitama, Japan

    Yojiro Hashiguchi MD, Kazuo Hase MD, Hideki Ueno MD, Eiji Shinto MD, Yoshihisa Naito MD, Yoshiki Kajiwara MD, Junji Yamamoto MD & Hidetaka Mochizuki MD

  2. Tokorozawa Proctologic Hospital, Saitama, Japan

    Toshihiko Kuroda MD

Authors
  1. Yojiro Hashiguchi MD
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  2. Kazuo Hase MD
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  3. Hideki Ueno MD
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  4. Eiji Shinto MD
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  5. Yoshihisa Naito MD
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  6. Yoshiki Kajiwara MD
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  7. Toshihiko Kuroda MD
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  8. Junji Yamamoto MD
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  9. Hidetaka Mochizuki MD
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Corresponding author

Correspondence to Yojiro Hashiguchi MD.

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Hashiguchi, Y., Hase, K., Ueno, H. et al. Impact of Race/Ethnicity on Prognosis in Patients Who Underwent Surgery for Colon Cancer: Analysis for White, African, and East Asian Americans. Ann Surg Oncol 19, 1517–1528 (2012). https://doi.org/10.1245/s10434-011-2113-5

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  • DOI: https://doi.org/10.1245/s10434-011-2113-5

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