Single disease entity for both chromosomal instable subtype gastric adenocarcinoma and esophageal adenocarcinoma.

Gastric cardiac carcinoma (GCC) was and is considered as a part of esophageal adenocarcinoma (EAC) and staged with the rules for EAC. This may change. Recent comprehensive integrated genomic investigations on gastric and esophageal carcinomas discovered similar chromosomal instability profiles in these two groups of carcinomas with a gradual increasing gradient from the lowest percentage in the distal gastric antrum to a high level in the proximal gastric cardia, and to the peak of almost 100% in EAC. Therefore, most GCCs and EAC share similar chromosomal instable features of gastric carcinoma and should be grouped as a single disease entity because EAC may be the proximal extension of chromosomal instable GCCs. This breakthrough discovery in genomic characteristics of GCC and EAC would dramatically change the strategy on how patients should be appropriately managed clinically and also greatly help future investigation on detailed molecular pathogenetic mechanisms of GCC, leading to cure this fatal cancer.