Original article: general thoracicResults of surgical treatment of adenocarcinoma of the gastric cardia
Section snippets
Material and methods
Between January 1988 and February 2000, 96 consecutive patients with histologically proven primary adenocarcinoma of the cardia underwent resection with curative intent at the First Division of General Surgery, University of Verona, Italy. Median age was 67 years (range, 27 to 84 years), and 84 patients were male. All of the 96 patients underwent the same staging workup including barium swallow, endoscopy with biopsy, and computed tomography of the chest and upper abdomen. Endosonography was
Results
The type of resections and reconstructions in relation to different Siewert type are reported in Table 1. In this series of 96 patients, the total number of dissected lymph nodes was 2,779, with an average (± standard deviation) of 29 ± 17.3 dissected nodes per case (median, 25.5; range, 1 to 108). The mean number of metastatic nodes was 7.5 ± 8.8 (median, 4.5; range, 0 to 39) in the overall series, and 9.3 ± 8.9 (median, 7; range, 1 to 39) in pN-positive patients. A mean of 16.4 ± 8.4 nodes
Comment
Numerous studies indicate an increase in the incidence of the adenocarcinoma of the gastroesophageal junction in Western countries 1, 2, 3, 4. The optimal treatment strategy is still a matter of debate given the peculiarities of this tumor, such as the spread to both the mediastinal and abdominal lymph nodes. In fact, the main lymphatic pathways originating from the lower esophagus advance both up into the mediastinum and down along the celiac axis [10], whereas those from the gastric cardia
References (29)
- et al.
Increasing incidence in adenocarcinoma of esophagus and esophago-gastric junction
Gastroenterology
(1993) - et al.
Clinical experience in radical lymphadenectomy for adenocarcinoma of the gastric cardia
J Thorac Cardiovasc Surg
(1997) - et al.
Adenocarcinoma of the gastroesophageal junction in Japanrelevance of Siewert’s classification applied to 177 cases resected at a single institution
J Am Coll Surg
(1999) - et al.
Rising incidence of adenocarcinoma of the esophagus and gastric cardia
JAMA
(1991) - et al.
Changing patterns in the incidence of esophageal and gastric carcinoma in the United States
Cancer
(1998) - et al.
New classification of esophageal and gastric carcinomas derived from changing patterns in epidemiology
Br J Cancer
(1999) - et al.
Kardiacarcinom. Versuch einer Therapeutisch Relevanten Klassifikation
Chirurg
(1987) - et al.
Adenocarcinoma of the esophagogastric junction. Results of surgical therapy based on anatomical/topographic classification in 1,002 consecutive patients
Ann Surg
(2000) - et al.
Carcinoma of the gastric cardia
Ann Chir Gynaec
(1995) - et al.
Application of the new classification for cancer of the cardia
Surgery
(1998)
Regione esofago-cardiale
Carcinoma of the cardiacarcinoma of the gastroesophageal junction—classification, pathology and extent of resection
Dis Esophagus
The new Japanese classification of gastric carcinoma
Gastric Cancer
Pancreas-preserving total gastrectomy for proximal gastric cancer
World J Surg
Cited by (65)
The surgical management of esophago-gastric junctional cancer
2016, Surgical OncologyClinical characteristics, biologic behavior, and survival after esophagectomy are similar for adenocarcinoma of the gastroesophageal junction and the distal esophagus
2009, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :We found that overall and disease-specific survival were similar for adenocarcinoma of the DE and GEJ and showed that both tumors are effectively treated with esophagectomy. Thus from a clinical standpoint, our study and others suggest that efforts to preoperatively determine whether the tumor is a DE adenocarcinoma or a GEJ adenocarcinoma are unnecessary.24 Our study is limited by the fact that it is retrospective, although this limitation is minimized by the fact that all patients were treated in a single high-volume center by experienced esophageal surgeons.
Factors predicting survival in patients with proximal gastric carcinoma involving the esophagus
2012, World Journal of GastroenterologyTranshiatal versus transthoracic esophagectomy for esophageal SCC: outcomes and complications
2022, Journal of Cardiothoracic SurgeryOptimal surgery for esophagogastric junctional cancer
2022, Langenbeck's Archives of Surgery