Faculty Bibliography

Recent immigrants to the USA form groups in which disease prevalence, recognition, treatment and outcome may vary from non-immigrant groups. NYU Downtown Hospital (NYUDH), at the Southern edge of NY City's Chinatown, serves the >50,600 Chinese immigrants who reside there. We performed a retrospective analysis of Tumor Registry data on stage at presentation and survival for all Chinese patients in whom colon cancer was diagnosed at NYUDH from 1994-8 and in whom staging was possible. Staging was determined by the American Joint Committee on Cancer criteria. We compared this to data from the National Cancer Institute Surveillance, Epidemiology and End Results Program (SEER). 214 patients were staged during this interval. For NYUDH patients the stage of presentation mode was 3 compared to stage 2 for the overall USA SEER data. The mean 5-year survival for stage 3 NYUDH patients was 64.7% compared to 64.4% for SEER. The mean 5-year survival for all staged NYUDH colon cancer patients was 47% compared to 61.1% for SEER. Conclusion: Immigrant Chinese patients in New York City's Chinatown who undergo surgery for colon cancer present with more advanced disease and have a poorer overall outcome than the average American

Operative gastrostomy (OG) for gastrointestinal decompression or feeding has stood the test of time. Nevertheless, this procedure is often associated with significant morbidity and occasional mortality. Furthermore, although it is often performed under local anesthesia, general anesthesia is frequently necessary. A recent alternative to OG is percutaneous endoscopic gastrostomy (PEG). The purpose of this study is to describe our experience with 100 consecutive PEGs in 98 patients. There were no complications, and no patient died as a result of PEG. Furthermore, PEG never required general anesthesia and was rapid and less costly than OG. Since PEG is so simple to perform, it may be employed earlier in the patient's course, thus avoiding nasogastric feedings or parenteral alimentation. PEG is the procedure of choice should gastrostomy be needed.