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KMID : 0365920020380120010
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Journal of the Pusan Medical Association
2002 Volume.38 No. 12 p.10 ~ p.18
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Clinical review on Cardia Cancer
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Kim Dong-Heon
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Abstract
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Background : Gastric cardia cancers is relatively rare neoplasm althougth it is reported that their relative incidence among gastric cancers is increasing. At the time of diagnosis, the most gastric cardia cancers are already in more advanced stage in terms of depth of invasion or metastasis to lymph nodes. The purpose of this study was to evaluate the effect of the proximal resection margin on the survival rates for cardia cancer patients who underwent a total gastrectomy except cases with thoracotomy and trans-hiatal esophagectomy.
Method : We retrospectively analyzed 110 patients who had undergone total gastrectomies for gastric cardia cancers located below esophagogastric junction at Pusan National University Hospital during the 16 years from Jan.1995 to Dec. 2000.
Results : The most prevalent age group was in the 6th decades(34.5%) and the male-to-female ratio was 1.8 : 1.0. The TNM classification showed sage Ⅰ(14.5%), Ⅱ(10.9%), Ⅲ(51.8%), and Ⅳ(22.8%). The overall 5-year survival rate was 35.6%, and the survival rates according to the stage were 83.3% to the length of the proximal resection margin(PRM) for all patients were as follows : 22.0% for PRM ≤2㎝(N=43) and 44% for PRM＞2㎝(N=66)(p=0.0783). The 5-year survival rates according to the length of the PRM for stage Ⅲ cancers were as follows : 19.7% for PRM ≤2㎝(N=22) and 31.7% for PRM＞ 2㎝(N=35)(p=0.4090).
Conclusion : These results suggest that the length of the PRM is not significant as a prognostic factor. We believe a total gastrectomy without a thoracotomy is a resonable and safe alternative to a thoracotomy approach to the dissection off the mediastinal lymph node in cases of gastric cardia cancer located below E-G Junction.
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KEYWORD
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Total gastrectomy, Cardia cancer
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