Carcinoma of the gastric cardia: Surgical management and long‐term survival

Abstract

Abstract From 1964 to 1985, a total of 114 patients (94 men and 20 women) were operated on. The resectability rate was 71%, and 53% of the patients were thought potentially curable. Either abdominal or combined abdominal and thoracic approaches were preferred. Proximal esophagogastrectomy (54 cases) was performed in cases with wide esophageal extension and total gastrectomy (27 cases) was performed for tumors localized in the gastric cardia. There was intraoperative examination of the esophageal margin. There was lymph node involvement in 57% of cases and esophageal extension in 59%. Three patients died in the postoperative course, none after curative resection. There was 1 (1.2%) clinical anastomotic leak. The overall 5‐year survival rate was 18.5%. The actuarial 5‐year survival rate was 29±8% after resection and 40±7% after curative resection, and the 10‐year survival rate was 20±7 and 28±7, respectively. Symptom duration, age, or sex had no significant influence on prognosis. Lymph node involvement, tumor depth penetration, and esophageal extension were the main prognostic factors .