The National Cancer Data Base Report on poor survival of U.S. gastric carcinoma patients treated with gastrectomy: Fifth Edition American Joint Committee on Cancer staging, proximal disease, and the "different disease" hypothesis.

Abstract

The current AJCC/International Union Against Cancer TNM staging system fails to accommodate the effect of proximal location on prognosis. Largely because Japanese Americans present with fewer proximal tumors, have a lower male-to-female ratio, and undergo adjacent organ resection less frequently, stage- stratified survival for Japanese Americans appears to be superior. In the U.S., surgical undertreatment of patients with this disease appears to be a problem.