584 Characterisation of Global Gastric Cancer Surgery Epidemiology: An International Prospective Cohort Study

Abstract Aim We aimed to characterise the global surgical gastric cancer population and variability in disease presentation across different resource settings. Method GlobalSurg3 was a multicentre, international prospective cohort study of patients undergoing surgery for cancer. Primary outcomes were death or major complications (Clavien-Dindo III/IV) within 30 days surgery. Income levels defined using World Bank classification. Patient characteristics, factors analysed income levels. Multilevel logistic regression models used explore effect patient on outcomes. Results This analysis included 1337 from 263 hospitals (high countries (HICs) N = 712, upper middle 289, low lower middle-income (LMICs) 336). Most presented with adenocarcinoma (81.4%, N=1088) distal third stomach (43.2%, N=578). Patients average 10 years younger LMICs compared HICs (55.4 vs 67.4), proportion presenting >10% weight loss double (64.3%, N=216 30.8%, N=219). twice as likely require emergency (10.7%, N=36 4.2%, N=30), did those operated palliative intent (21.1%, N=71 11.1%, N=79). Having an increased Eastern Cooperative Oncology Group performance status (ECOG) associated significantly 30-day mortality (ECOG 2 aOR= 7.99 (2.67–23.94, p<0.001), ECOG 3/4 13.31 (4.04–43.89, p<0.001)). Conclusion Functional is independently after Variation may be influenced by inherent differences between populations.