Race and Correlations Between Lymph Node Number and Survival for Patients with Gastric Cancer

Background: There is ongoing debate whether extended lymphadenectomy improves survival in gastric cancer patients who undergo surgical resection. We previously observed that Korean-American patients had the highest overall survival in Los Angeles County. Our objective was to assess lymph node (LN) number and its impact on survival for Korean-American gastric cancer patients. Methods: We utilized the National Cancer Institute's Surveillance, Epidemiology, and End Results registry to identify Korean-Americans with gastric adenocarcinoma treated with curative-intent gastrectomy between 1988 and 2008. We grouped patients according to examined LN number (1-15 and 16+) and compared characteristics. We performed similar analysis for white patients. Results: Out of 982 Korean-American patients with gastric adenocarcinoma, most patients had 1-15 examined LNs (60 %). When we compared LN groups, we observed higher overall survival in the 1-15 group than the 16+ group (5-year survival, 59 % vs 52 %, respectively; p = 0. 04). However, LN number was not prognostic of overall survival on stepwise Cox proportional hazards analysis. In contrast, LN number was prognostic for white patients. Conclusions: Although examined LN number may impact survival for white patients, outcomes of Korean-American gastric cancer patients were independent of LN number. Our data suggest that survival of Korean-American gastric cancer patients are comparable with outcomes from East Asian hospitals and may be independent of surgical technique.