Carcinoma of the Gastric Cardia: Surgical Practices and Short‐term Operative Results in a Defined Swedish Population

Abstract

Adenocarcinoma of the gastric cardia has one of the most rapidly increasing incidence rates of all tumors in Western countries. The aim of this population-based investigation was to study surgical practices and postoperative morbidity and mortality during routine hospital care. The study comprised 176 patients given a new diagnosis of adenocarcinoma of the gastric cardia from February 1, 1989 to the January 31, 1995 in five Swedish counties. The tumor was resectable in 100 (57%) patients (in 36% of the women and 64% of the men), but only 46% of all patients could be offered a potentially curative operation. A total gastrectomy was performed in 54 patients and a proximal gastric resection in 44. Postoperative complications occurred in 39%: in 20% of the patients under age 60 years and in 47% of those aged 60 and over (p = 0.006). Seventeen operated patients (13%) died before discharge. The hospital mortality increased from 3% among those < 60 years of age to 18% among those > 69 years (p = 0.041). Surgical treatment of carcinoma of the gastric cardia carries substantial morbidity and mortality. No important progress seems to have taken place since the 1960s.

Analysis of Clinicopathological Prognostic Parameters in Adenocarcinoma of the Gastric Cardia

“…Adenocarcinoma of the gastric cardia has a poor prognosis (11). Although 60-80% of the tumours are resectable, only 30% of them are at favourable stages I or II (1,8,12).…”

Study of the value of combined multiorgan resection in surgical treatment of carcinoma of the gastric cardia

“…(2) If there were metastases to the lymph nodes at the splenic hilus or along the splenic artery. Based on the developmental anatomy, Lin ［7］ reported that by removal of the pancreatic body and tail, spleen and stomach en bloc with a cutting out of the pancreas at the junction of the head and body, he was able to completely provide dissection of the lymph nodes at the splenic hilus and along the splenic artery.…”

“…Therefore a total or partial resection of the invaded organs was necessary to obtain a curative resection [2] . The second reason was to facilitate more extensive regional lymph node dissection involving mainly the lymph node stations 10 and 11 and the pancreas and spleen.…”