Sex Disparity in Gastric Cancer: Female Sex is a Poor Prognostic Factor for Advanced Gastric Cancer

Hae Won Kim, Jie Hyun Kim, Beom Jin Lim, Hyun Ki Kim, Hoguen Kim, Jae Jun Park, Young Hoon Youn, Hyojin Park, Sung Hoon Noh, Jong Won Kim, Seung Ho Choi

Research output: Contribution to journalArticlepeer-review

66 Citations (Scopus)


Background: The overall incidence of gastric cancer (GC) is higher in males than females. Specifically, signet ring cell carcinoma (SRC) is more frequently observed in younger female patients. However, limited information focused on sex-specific differences in GC has been reported. The aim of our study was to analyze clinicopathological differences between sex groups to reveal sex disparities in GC. Methods: We retrospectively analyzed 4722 patients with GC who underwent gastrectomy (females: 1586 (33.6 %); males: 3136 (66.4 %), and analyzed clinicopathological features between these sex groups. The overall survival (OS) rate was investigated between the two sex groups, with special reference to the pathologic World Health Organization GC classifications. Immunohistochemistry staining of sex hormone receptors, including the estrogen receptor (ER)-α, ER-β, progesterone receptor, and androgen receptor, was performed according to sex and pathological classification. Results: Female patients were significantly associated with a younger age, poorly differentiated adenocarcinoma, and SRC compared with males. Female patients showed a significantly poorer OS than male patients, especially among those with advanced GC (AGC) aged ≤45 years. In females with AGC, those with SRC had a significantly poorer OS than those with other histologies. Moreover, the expression of ER-β was different between females and males with SRC. Conclusions: Females with GC were significantly younger and had a different SRC histology compared with males. Furthermore, females had significantly poorer prognostic factors among young patients with SRC. Thus, young female GC patients with SRC are a main target group in which to improve prognosis.

Original languageEnglish
Pages (from-to)4344-4351
Number of pages8
JournalAnnals of surgical oncology
Issue number13
Publication statusPublished - 2016 Dec 1

Bibliographical note

Publisher Copyright:
© 2016, Society of Surgical Oncology.

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology


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