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KMID : 0371320080740020341
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Journal of the Korean Surgical Society
2008 Volume.74 No. 2 p.341 ~ p.346
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Cardia Cancer: Personal Experience
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Yoon Ho-Young
Kim Kuk-Jin
Lee Sang-Hoon
Kim Choong-Bai
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Abstract
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Purpose: Due to the biological characteristics of cardia cancer, prognosis is poor. It is therefore essential to achieve a sufficient proximal resection margin to maximize survival. The authors studied gastric cardia cancer, focusing on adenocarcinoma.
Methods: One-hundred fifty patients who were diagnosed with gastric cardia cancer and underwent surgery between January 1990 and December 2006 by a single surgeon were included in this study.
Results: Of the 150 cases, 141 were adenocarcinomas, 4 were carcinomas, and 3 were leiomyosarcomas. In the adenocarcinoma group, the male-to-female ratio was 2.62:1. There were 2, 60, and 79 (56.0%) cases of adenocarcinoma type I, II, and III, respectively, and there were 32 (22.7%), 18 (12.8%), 70 (49.6%), and 21 (14.9%) cases of stage I, II, III, and IV tumors, respectively. The mean distance from the proximal tumor to the resection margin was 1.93±1.72 cm pathologically, and there was tumor invasion of the resection margin in 4 cases (2.8%). In the 10 cases of extended surgery in type II, the mean distance was 5.85±3.67 cm, with no tumor invasion of the resection margin. Recurrence occurred in 30 (21.3%) cases, and 5 of those cases were local anastomotic site recurrences. Cumulative survival was 81.3%, 77.8%, 51.4%, and 28.6% for stage I, II, III, and IV tumors, respectively.
Conclusion: Although it is possible to remove the tumor with an appropriate resection margin by only an abdominal incision, the surgeon should always keep in mind the possibility of a thoracoabdominal incision when operating on a patient with esophageal infiltration. (J Korean Surg Soc 2008;74:341-346)
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KEYWORD
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Cardia cancer, Siewert classification, Gastroesophageal junction
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