The prognosis of gastric cardia cancer after R0 resection

Am J Surg. 2010 Jun;199(6):725-9. doi: 10.1016/j.amjsurg.2009.04.012. Epub 2009 Oct 17.

Abstract

Background: The aim of this study was to evaluate the prognosis of gastric cardia cancers in comparison with other gastric cancers.

Methods: The medical records of 251 patients with gastric cardia cancers and 6568 patients with other gastric cancers who underwent R0 resection were reviewed. Clinicopathologic characteristics and survival were analyzed.

Results: Gastric cardia cancer was associated with more advanced staging and less favorable clinicopathologic features at diagnosis compared with other gastric cancers. The overall 5-year survival rates were 79.7% and 84.6% in patients with cardia cancer and other cancers, respectively. There were no significant differences in survival curves between the groups at any stage. Lymph node metastasis was an independent prognostic factor for disease-free survival. The length of the proximal margin was not associated with locoregional tumor recurrence.

Conclusions: Although patients with gastric cardia cancers are diagnosed at an advanced stage, the long-term survival rates are similar to those with other gastric cancers. If curative resection with negative resection margin can be achieved, pN category is the only prognostic factor for survival.

MeSH terms

  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery*
  • Cardia / pathology
  • Cardia / surgery*
  • Disease-Free Survival
  • Female
  • Humans
  • Lymphatic Metastasis / pathology
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Proportional Hazards Models
  • Statistics, Nonparametric
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*