Genomic and clinical parallels between US and Japanese gastric cancers: a propensity score-matched cohort study.

IF 9.4 1区医学 Q1 SURGERY

British Journal of Surgery Pub Date : 2025-11-29 DOI:10.1093/bjs/znaf280

Masaya Nakauchi,Colin Court,Henry S Walch,Miseker Abate,Shoji Shimada,Walid K Chatila,Laura H Tang,Daniel G Coit,Yelena Y Janjigian,Steven B Maron,Geoffrey Y Ku,David H Ilson,Nikolaus Schultz,Hiroshi Matsuoka,Tetsuya Tsukamoto,Ichiro Uyama,Koichi Suda,Vivian E Strong

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引用次数: 0

Abstract

INTRODUCTION Gastric cancer incidence, risk factors, and survival outcomes differ significantly between Japan and the United States. These disparities have led to the belief that gastric cancer represents biologically distinct diseases across regions. However, direct genomic comparisons of tumours from these populations have not been performed. The aim of this study was to compare the genomic and clinical characteristics of gastric cancers in patients from the US and Japan following curative-intent resection. METHODS A retrospective cohort study of patients who underwent curative-intent gastrectomy between 2010 and 2019 at Memorial Sloan Kettering (MSK, n = 142) and Fujita Health University (FHU, n = 108), with ≥5 years of follow-up, was conducted. Tumour samples underwent targeted sequencing. Clinical and genomic data were compared between unmatched and propensity score-matched (PSM) cohorts, matched by age, sex, clinical T/N-category, and tumour location (n = 58 each). RESULTS Commonly altered genes included TP53 (60%), ARID1A (17%), ERBB2 (14%), CCNE1 (13%), and KRAS (12%). MSK tumours showed higher rates of microsatellite instability (MSI-high; 22.4% versus 5.2%, P = 0.013) and KMT2D mutations (18% versus 5%, P < 0.05). Otherwise, gene- and pathway-level alterations were similar across unmatched, microsatellite stable only, and PSM cohorts. Five-year overall survival in PSM cohorts was comparable (MSK 60% versus FHU 69.4%, P = 0.548). Peritoneal recurrence was more common in the MSK cohort (47% versus 34%), but recurrence patterns were not associated with distinct genomic profiles. CONCLUSION After adjustment for clinical covariates, US and Japanese gastric cancers exhibit comparable genomic landscapes and survival, supporting the relevance of clinical trial data across geographic settings.

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美国和日本胃癌的基因组和临床相似性：一项倾向评分匹配的队列研究。

日本和美国的胃癌发病率、危险因素和生存结局存在显著差异。这些差异导致人们相信，胃癌在不同地区代表着生物学上不同的疾病。然而，还没有对这些人群的肿瘤进行直接的基因组比较。本研究的目的是比较美国和日本胃癌患者在治疗目的切除后的基因组和临床特征。方法回顾性队列研究2010年至2019年期间在纪念斯隆凯特琳（MSK, n = 142）和藤田健康大学（FHU, n = 108）接受治愈性胃切除术的患者，随访≥5年。肿瘤样本进行了靶向测序。临床和基因组数据在未匹配和倾向评分匹配（PSM）队列之间进行比较，按年龄、性别、临床T/ n类别和肿瘤位置进行匹配（每个n = 58）。结果常见的改变基因包括TP53（60%）、ARID1A（17%）、ERBB2（14%）、CCNE1（13%）和KRAS（12%）。MSK肿瘤具有较高的微卫星不稳定性（msi高，22.4%比5.2%,P = 0.013）和KMT2D突变（18%比5%，P < 0.05）。否则，基因和通路水平的改变在未匹配的、微卫星稳定的和PSM队列中是相似的。PSM队列的5年总生存率具有可比性（MSK为60%，FHU为69.4%,P = 0.548）。腹膜复发在MSK队列中更为常见（47%对34%），但复发模式与不同的基因组谱无关。在调整临床协变量后，美国和日本的胃癌表现出相似的基因组景观和生存率，支持不同地理环境下临床试验数据的相关性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

British Journal of Surgery 医学-外科

CiteScore

12.70

自引率

7.30%

发文量

1102

审稿时长

1.5 months

期刊介绍： The British Journal of Surgery (BJS), incorporating the European Journal of Surgery, stands as Europe's leading peer-reviewed surgical journal. It serves as an invaluable platform for presenting high-quality clinical and laboratory-based research across a wide range of surgical topics. In addition to providing a comprehensive coverage of traditional surgical practices, BJS also showcases emerging areas in the field, such as minimally invasive therapy and interventional radiology. While the journal appeals to general surgeons, it also holds relevance for specialty surgeons and professionals working in closely related fields. By presenting cutting-edge research and advancements, BJS aims to revolutionize the way surgical knowledge is shared and contribute to the ongoing progress of the surgical community.