The prognosis of gastric cardia cancer after R0 resection

An, Ji Yeong; Baik, Yong Hae; Choi, Min Gew; Noh, Jae Hyung; Sohn, Tae Sung; Bae, Jae Moon; Kim, Sung

doi:10.1016/j.amjsurg.2009.04.012

« Previous Next »The American Journal of Surgery
Volume 199, Issue 6 , Pages 725-729, June 2010

The prognosis of gastric cardia cancer after R0 resection

Ji Yeong An, M.D.
- Department of Surgery, College of Medicine, Yonsei University, Seoul, South Korea
Yong Hae Baik, M.D.
- Department of Surgery, Dongguk University, Ilsan Hospital, Goyang, South Korea
Min Gew Choi, M.D.
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Jae Hyung Noh, M.D.
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- Corresponding author: Tel.: 82-2-3410-3470; fax: +82-2-3410-0929
Tae Sung Sohn, M.D.
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Jae Moon Bae, M.D.
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Sung Kim, M.D.
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

Received 5 February 2009; received in revised form 10 April 2009 published online 19 October 2009.

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.

Keywords: Esophagogastric junction, Cardia, Gastric cancer, Prognosis, Surgery