Niu PH, Zhao LL, Wang WQ, Zhang XJ, Li ZF, Luan XY, Chen YT. Survival benefit of younger gastric cancer patients in China and the United States: A comparative study. World J Gastroenterol 2023; 29(6): 1090-1108 [PMID: 36844138 DOI: 10.3748/wjg.v29.i6.1090]
Corresponding Author of This Article
Ying-Tai Chen, MD, Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Beijing 100021, China. yingtaichen@126.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Peng-Hui Niu, Lu-Lu Zhao, Wan-Qing Wang, Xiao-Jie Zhang, Ze-Feng Li, Xiao-Yi Luan, Ying-Tai Chen, Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Author contributions: Niu PH, Zhao LL, and Wang WQ contributed equally to this work and share first authorship. All authors made substantial contributions to the intellectual content of this paper.
Supported byNational Key R&D Program of China, No. 2017YFC0908300.
Institutional review board statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. This study was approved by the ethics committee of National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (No. 17-156/1412).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
Data sharing statement: The data used to support the findings of this study are included within the article in Tables.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ying-Tai Chen, MD, Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Beijing 100021, China. yingtaichen@126.com
Received: August 24, 2022 Peer-review started: August 24, 2022 First decision: November 5, 2022 Revised: December 11, 2022 Accepted: January 5, 2023 Article in press: January 5, 2023 Published online: February 14, 2023 Processing time: 170 Days and 2.2 Hours
ARTICLE HIGHLIGHTS
Research background
The impact of racial and regional disparity on younger patients with gastric cancer (GC) remains unclear.
Research motivation
This study aimed to provide a national view of younger GC patients in China and the United States.
Research objectives
To investigate the clinicopathological characteristics, prognostic nomogram, and biological analysis of younger GC patients in China and the United States.
Research methods
From 2000 to 2018, GC patients aged less than 40 years were selected from the China National Cancer Center and the Surveillance Epidemiology and End Results database. Biological analysis was enrolled from the Gene Expression Omnibus database.
Research results
A total of 6098 younger GC patients were selected from 2000 to 2018, of which 1159 were enrolled in the China National Cancer Center, and 4939 were collected from the Surveillance Epidemiology and End Results database. Compared with the United States group, younger patients in China revealed better survival outcomes (P < 0.01). For race/ethnicity, younger Chinese cases also enjoyed a better prognosis than that in White and Black subsets (P < 0.01). Prognostic nomograms for younger patients were established, with area under the curves of 0.786 for China and 0.842 for the United States. Moreover, three gene expression profiles (GSE27342, GSE51105, and GSE38749) were enrolled in further biological analysis, and distinctive molecular characteristics were identified in younger GC patients in different regions.
Research conclusions
Except for younger cases with pathological Tumor-Node-Metastasis stage II, a survival advantage was observed in the China group with pathological stages I, III, and IV. Biological analysis of younger patients was performed among different regions, which might partly explain the histopathological behaviors and survival disparity in the subpopulations.
Research perspectives
Further large-scale studies are warranted to investigate more molecular characteristics and related mechanisms for younger GC patients among different regions and races.
