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KMID : 0390119920320010063
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Journal of Pusan Medical College
1992 Volume.32 No. 1 p.63 ~ p.76
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A Clinical Study on the Cancer of the Gastric Cardia
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Abstract
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The name 'cardia' to denote the mouth of the stomach has been attributed to Galen, and malignant tumors of this region are known as cardia carcinomas The definition is, however, not unequivocal. Accoridng to the Zacho and Fischermann's
definition,
it is
an area within approximately 5㎝ from the esophagogastric junction and according to the definition of Nishi and his associated, it is an area within 2㎝ each proximal & distal to the esophagogastric junction.
Carcinomas of the gastric cardia are relatively rare neoplasa although it is reported that their relative incidneces among gastric carcinomas have increased in recent years. Operative tactics forces surgeons to deal with their tumor as if they
were
esophageal tumors, whereas from an oncologic point of view of the distal esophagus and adenocarcinoma of the other site of stomach. This paper presents a clinical analysis and the prognosis of 48 cases of carcioma of the gastric cardia treated at
Dept.
of Surgery Pusan National University Hospital from Jan. 1981 to Dec. 1990.
The results were as follows :
1) The incidence of the carcinoma of gastric cardia was 48 cases (4.8%) of 993 cases of gastric cancer and the prevalent age was 6th decade and there was a male preponderence with a male to female ratio of 3.4 : 1.
2) In the grosc findings. the ulcerated type was most common and 11 cases(39.3%) of 28 cases of cancer of gastric cardia.
3) In the 32 cases of cancers of gastric cardia, adenocarcinomas were 24 cases (75.0%), the predominent portion of histologic types was poorly differentiated type. The types were 10 cases(31.3%).
4) According to TMN classification, there were 18 cases (56.3%) in stage III and 8 cases (25.0%) in stage II.
5) Total gastrectomy was performed in 14 (43.8%) of 32 cases, and esophagogastrectomy with thoracotomy in 8 (25.0%) of 32 cases. By the way, esophageal resection was performed at least 6~8㎝ above the palpable mass.
6) Overall postoperative complication rate was 21.9% and mortality rate was 6.3%. The cause of death was a repiratory failure with pericardial effusion and a hepatic failure with renal failure.
7) Three year survival rate was 60.0% in stage II and 25.0% in stage III. Two year surival rate using the total gastrectomy for tumors of the cardia was 38.5%, 83.3% using the esophagogastrectomy with thoracotomy, and 33.3% using
esophagogastrectomy
without thoracotomy.
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