Authors: Hiroaki Saito Youji Fukumoto Tomohiro Osaki Kenji Fukuda Shigeru Tatebe Shunichi Tsujitani Masahide Ikeguchi
Publish Date: 2006/09/07
Volume: 30, Issue: 10, Pages: 1864-1869
Abstract
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 prognosisTumors of the cardia had a mean size of 68 cm which was significantly larger than the mean size of 59 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 5year survival rates were 616 791 and 826 in patients with carcinoma of the cardia upper onethird and remaining middle and lower onethird 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
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