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World Journal of Surgery

, Volume 30, Issue 10, pp 1864–1869 | Cite as

Distinct Recurrence Pattern and Outcome of Adenocarcinoma of the Gastric Cardia in Comparison with Carcinoma of Other Regions of the Stomach

  • Hiroaki SaitoEmail author
  • Youji Fukumoto
  • Tomohiro Osaki
  • Kenji Fukuda
  • Shigeru Tatebe
  • Shunichi Tsujitani
  • Masahide Ikeguchi
Article

Abstract

Background

Carcinoma arising in the cardioesophageal junction is a distinct clinical entity compared with tumors located in other regions of the stomach. The prognosis for adenocarcinoma of the upper stomach is considered to be relatively poorer than carcinomas of the more distal stomach. We have therefore investigated patients with carcinoma of the gastric cardia in order to evaluate the underlying cause of this poor prognosis.

Materials and Methods

Clinicopathologic features and postoperative prognosis of 101 patients with carcinoma of the cardia were evaluated and compared with findings on 1884 patients with tumors in other regions of the stomach.

Results

Tumors of the cardia had a mean size of 6.8 cm, which was significantly larger than the mean size of 5.9 cm for tumors found in the middle- and lower third of the stomach. The incidence of serosal invasion, lymph node metastasis, and lymphatic and blood vessel invasion was higher in association with adenocarcinoma of the cardia than with adenocarcinoma in remaining parts of the stomach. In the analysis of patients who had undergone curative resection, the 5-year survival rates were 61.6, 79.1, and 82.6% in patients with carcinoma of the cardia, upper one-third, and remaining middle- and lower one-third of the stomach, respectively, and the differences were statistically significant. Multivariate analysis indicated that adenocarcinoma of the gastric cardia is an independent prognostic factor. With regard to the site of recurrence, both lymph node and hematogenous recurrence were observed more frequently in the cardia than in the remaining parts of the stomach.

Conclusions

Our data indicate that the prognosis of patients with adenocarcinoma of the gastric cardia is extremely poor. To improve their prognosis, new treatments in addition to gastrectomy with extensive lymph node dissection are needed.

Keywords

Celiac Axis Left Gastric Artery Gastric Cardia Peritoneal Recurrence Hematogenous Metastasis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Société Internationale de Chirurgie 2006

Authors and Affiliations

  • Hiroaki Saito
    • 1
    Email author
  • Youji Fukumoto
    • 1
  • Tomohiro Osaki
    • 1
  • Kenji Fukuda
    • 1
  • Shigeru Tatebe
    • 1
  • Shunichi Tsujitani
    • 1
  • Masahide Ikeguchi
    • 1
  1. 1.Department of Surgery, Division of Surgical OncologyTottori University School of MedicineYonago Japan

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