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Epstein-Barr virus positivity as a prognostic indicator in gastric cancer: An international pooled analysis

Thursday, October 11, 2012 — Poster Session III

10:00 a.m. – Noon

Natcher Conference Center, Building 45



* FARE Award Winner


  • M.C. Camargo
  • W.H. Kim
  • A.M. Chiaravalli
  • K.M. Kim
  • A.H. Corvalan
  • K. Matsuo
  • J. Yu
  • J.J.Y Sung
  • R. Herrera-Goepfert
  • F. Meneses-Gonzalez
  • Y. Kijima
  • S. Natsugoe
  • W.H. Chow
  • J. Lissowska
  • S. Kim
  • C. Koriyama
  • S. Akiba
  • C.A. Gonzalez
  • P.R. Taylor
  • C.S. Rabkin


Background: Epstein-Barr virus (EBV) is present in the tumor cells of up to 10% of gastric carcinomas. We examined the association of EBV with overall survival after gastric cancer diagnosis in a large multi-center case series, accounting for surgical stage and other prognostic factors. Methods: Thirteen studies conducted in Asia (n=8), Europe (n=3) and Latin America (n=2) recruited a total of 4,526 cancer patients, with 8% prevalence of EBV. Study-specific hazard ratios (HRs) for survival were estimated using Cox regression models, adjusted for age, sex, surgical stage, degree of differentiation, and anatomic subsite. The 13 HRs were pooled for a summary estimate by a random-effects model. Between-study heterogeneity was quantified with the I2 metric and statistical significance assessed by the Q statistic. Results: As expected, stage was strongly associated with risk of death (pooled HR= 2.5 per stage; 95% confidence interval= 2.0 to 3.1). Stage was inversely associated with EBV positivity (p <0.001). Adjusted for stage and the other potential confounders, there was a significant survival advantage of EBV-positivity (pooled HR= 0.7; 95% confidence interval= 0.5 to 0.9), with low heterogeneity across studies (p=0.18). Conclusion: Our findings indicate that EBV positivity may be an additional prognostic indicator in gastric cancer.

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