Gender Differences in Patients with Gastric Adenocarcinoma.

Background : Gastric cancer (GC) epidemiology and outcomes vary by gender. Methods : We reviewed 18,436 GC patients from 2008 to 2018 and looked for gender differences in clinical characteristics and survival. Results : The gender proportion was 71% male and 29% female. Males had a significantly ( p < 0.001) higher proportion of differentiated GC (66.3%) and a lower proportion of undifferentiated GC (26.3%). Diagnosis through medical check-ups was more common in males (30.0% vs. 26.4%, p < 0.001). Clinical staging revealed 54.6% of males and 52.9% of females had localized disease without lymph node metastasis (LNM), while distant metastasis occurred in 17.4% of males and 16.9% of females ( p < 0.001). Kaplan-Meier survival curves indicated females had a significantly higher overall survival ( p = 0.0018). The survival advantage for females was evident in the early stages, with a significant difference in localized disease without LNM ( p < 0.001) and localized disease with LNM ( p = 0.0026, log-rank test) but not in the advanced stages. Multivariate Cox regression analysis showed a significantly reduced mortality risk in females ( p < 0.001). Conclusions : Significant gender differences exist with regard to pathological type, presentation, clinical stage, and overall survival. These findings suggest gender-specific strategies for screening, diagnosis, and treatment.