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Gastric cancer metastasis patterns and racial disparities: SEER database population study 2010-2019
Metastasis is a poor prognostic factor for gastric cancer. Disparities between African-Americans and Caucasians in metastasis patterns require further investigation. Thus, this study aims to compare the patterns of metastasis between African-Americans and Caucasians among different histological subtypes of gastric cancer.
We obtained data of 38,625 patients from Surveillance, Epidemiology, and End Results Program (SEER) database from 2010-2019. We extracted data of patients with adenocarcinoma, signet ring cell carcinoma, stromal sarcoma and carcinoid tumor who presented with metastasis to bone, brain, liver, or lung at the time of diagnosis. We calculated the relative risk (RR) and confidence interval (CI) using SPSS software, version 25.0 (IBM).
Liver was the most common site of metastasis across the different subtypes of gastric cancer. Adenocarcinoma was the most prevalent subtype of gastric cancer. Compared to African-Americans, Caucasians with adenocarcinoma had higher risk of bone and brain metastasis (RR=1.35, 95% CI 1.13-1.62, P=0.001 and RR=1.96, 95% CI 1.18 to 3.26, P=0.008, respectively) (Table 1). On the other hand, Caucasians with adenocarcinoma had lower risk of liver metastasis (RR=0.86, 95% CI 0.80-0.92, P>0.001). Additionally, Caucasians with stromal sarcoma also had lower risk of liver metastasis (RR=0.74, 95% CI 0.61-0.90, P=0.004). Signet ring cell carcinoma and carcinoid tumor showed no statistically significant differences between Caucasians and African-Americans regarding the risk of metastasis.
Across multiple subtypes of gastric cancer, adenocarcinoma was the most prevalent subtype, and it showed varying tendencies of metastasis between Caucasians and African-Americans. Such discrepancy in tumor metastatic behavior between races can guide, and even prioritize, different screening modalities for patients. It also warrants further studying of the patients’ genetic and biological factors.
The authors.
Has not received any funding.
All authors have declared no conflicts of interest.
