1; SAS Institute, Cary, NC). Results Patient baseline characteristics The final cohort for analysis consisted of 13,840 patients, 8710 men (63%), and 5130 women (37%). Their age distribution is as follows: 1,207 (9%) aged 18−44; 1,698 (12%) aged 45−54; 2,701 (20%) aged 55−64; 3,901 (28%) aged 65−74; and 4,333 (31%) aged 75 years and older. The median age was 68 years (range: 18−104). 60% of the MGC cohort were White, 13% African American, 13% Asian, 14 % Hispanic, Inhibitors,research,lifescience,medical and 1% Native American. Tumor characteristics and treatment received are shown in Table 1. Table 1 Overall survival of patients with metastatic gastric cancer by demographic and clinicopathologic

characteristics and treatment, SEER data 1988-2004 Age and ethnicity in MGC 5.5 % of Whites with MGC were between 18-44 years of ages as compared to 10% of African Americans, 11% of Asians, and 19% of Hispanic patients. 36% of White gastric cancer patients were diagnosed over 75 years of Inhibitors,research,lifescience,medical age; 29% of Asian, 27% of AA, and 20% of Hispanic. Tumor location: cardia vs non-cardia The incidence of cardia and non-cardia tumors varied significantly depending on gender and ethnic

background. 30% of men and 14% of women had gastric ca arising from the cardia. The incidence of cardia cancers also varied significantly Selleck MLN8237 across ethnicities. 32% of Whites had cardia Inhibitors,research,lifescience,medical primaries, 13% of AA’s, 11% of Asians, and 14% of Hispanics. Survival analysis The median overall survival (OS) in patients with MGC was only 4 months. The prognostic significance of several clinical and tumor characteristics were limited as the median OS varied little when stratified by sex, race, tumor site, grade/ differentiation, and histology Inhibitors,research,lifescience,medical (Table 1). However, age, use of local treatment, tumor differentiation,

and tumor site were found to have a clinically significant effect. The youngest group of patients had an improved OS when compared to their older counterparts (Table 1), as the median OS for patients 44 years or younger was 6 months compared to Inhibitors,research,lifescience,medical 3 months in patients 75 years or older. Survival was significantly worse in every successive age decile. Patients who had received any treatment had significantly improved survival. Gastrectomy or local surgery had a median OS of 8 months compared to a median OS of 3 months in patients who were not treated with surgery and or radiation [HR = 0.600 (0.561, 0.643)] (Table 1). Similarly, patients receiving radiation treatment had a survival benefit [HR = 0.802 (0.746, 0.862)]. Tumor characteristics had a significant impact on survival. As expected, patients with poorly differentiated tumors had a worse survival than those with moderately or well differentiated tumors [HR 1.19, P < 0.001 (1.139, 1.250)]. We also found that tumors located in the gastric cardia conferred a survival benefit when compared to non-proximal tumors [HR=0.945, P < 0.001 (0.904, 0.989)].