Registry of gastric cancer treatment evaluation (REGATE): II treatment practice

Abstract

AimsThe objective of the registry of gastric cancer treatment evaluation (REGATE) study was to evaluate approaches to gastric cancer treatment in different geographical regions. MethodsREGATE enrolled patients with newly diagnosed gastric cancer at any stage of the disease from the Asia-Pacific region, Europe, the Indian subcontinent, Latin America and North Africa between 2004 and 2008. ResultsAmong 9965 patients, 69% received surgery, 40% palliative care, 29% adjuvant therapy and 2% neoadjuvant therapy; 15% received no treatment. Combination treatment (mostly surgery/adjuvant) was used in one-third of patients. Overall, 90% received chemotherapy (mostly fluoropyrimidine/platinum combinations but with marked geographical variation) and 21% received radiotherapy. Curative surgery alone was used most frequently for stages 0-II cancers and was employed more often in Europe (55%) and the Asia-Pacific (48%) than in other regions (27-35%). Asia-Pacific and Indian subcontinent patients were more likely to have a distal subtotal gastrectomy and less likely to undergo total gastrectomy than patients in other regions. Lymph node D2 dissection was favored in the Asia-Pacific, Europe and Latin America, whereas D1 dissection was used more in the Indian subcontinent and North Africa. ConclusionThese data showing geographical differences in the approaches to gastric cancer treatment may promote the optimization of the management of gastric cancer globally.