Gender Differences in Gastric Cancer Survival: 99,922 Cases Based on the SEER Database

Objectives To evaluate gender differences in initial presentation, pathology and outcomes with GC (GC). Methods The 1973-2013 Surveillance Epidemiology and End Results (SEER) 17-registry database was analysed for renal tumours from 1973 to 2013 coded as primary site stomach. After various exclusions, a final study group of 99,922 cases with complete data was obtained. Demographic variables analysed included age, sex, marital status and race. Tumour variables included size, stage at diagnosis, grade, primary site, treatment and histology. Primary outcome variables included overall survival (OS) and cancer-specific survival (CSS). Results Overall, 96,501 gastric cancer patients were identified. Of those, 34,862 (36.2%) were women. For woman, log-rank test showed that OS and CSS were significantly longer in man (p < 0.0001). In Cox regression analysis, woman was associated with a significantly improved OS [(HR of death in 1973 to 2003 = 0.87, 95% CI = 0.85-0.89,P < 0.001) (HR of death in 2004 to 2013 = 0.94, 95% CI = 0.91-0.97,P < 0.001)] and cancer-specific survival [(HR of death in 1973 to 2003 = 0.90, 95% CI = 0.87-0.92,P < 0.001) (HR of death in 2004 to 2013 = 0.90, 95% CI = 0.87-0.93,P < 0.001)]. When performing a Kaplan-Meier curve analysis after propensity score matching, gender persisted to be a significant survival of woman for OS and CSS. Conclusions Men present with larger, higher stage, higher grade GC than women. OS and CSS are better in women, which is significantly different.