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

Aims: The objective of the registry of gastric cancer treatment evaluation (REGATE) study was to evaluate approaches to gastric cancer treatment in different geographical regions. Methods: REGATE 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. Results: Among 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. Conclusion: These data showing geographical differences in the approaches to gastric cancer treatment may promote the optimization of the management of gastric cancer globally.