Race/Ethnicity Is Predictive of Lymph Node Status in Patients with Early Gastric Cancer

Race/ethnicity has long been suspected to affect survival in patients with gastric adenocarcinoma. However, the clinicohistopathological impact of race or ethnicity on early gastric cancer (EGC) is not known. From 2000 to 2013, 286 patients underwent gastrectomy and 104 patients had pathological confirmation of EGC. A retrospective analysis of pathological and clinical prognostic indicators was performed. The study population consisted of 38 (37 %) Asian Americans and 66 (63 %) non-Asian Americans. Of these, 2 (5.3 %) Asian Americans and 19 (28.8 %) non-Asian Americans had pathological confirmation of lymph node metastasis (LNM) (p = 0.004). Univariate analysis comparing the clinicohistopathological characteristics in each group did not reveal significant difference regarding histotype, tumor size, grade, location, morphology, or lymphovascular invasion, except for the LNM rate and mean body mass index (23.2 versus 26.6, p < 0.001). Multivariate analysis showed that non-Asian race/ethnicity (odds ratio (OR), 9.09; 95 % confidence interval (CI), 1.12-71.43; p = 0.038), younger age (OR, 1.11; 95 % CI, 1.01-1.12; p = 0.046), and lymphovascular invasion (OR, 13.9; 95 % CI, 2.40-79.99; p = 0.003) were significant predictors for LNM. This study demonstrated that Asian American race in EGC is associated with a significantly decreased rate of LNM in comparison to non-Asian Americans, despite similar histopathological characteristics of each group.