Analysis of clinicopathological prognostic parameters in adenocarcinoma of the gastric cardia.

BACKGROUND: The optimal extent of resection for carcinoma of gastric cardia remains a subject of controversy. Although both total gastrectomy (TG) and proximal gastrectomy (PG) have their own advantages, similar survival rates were given for both. The main aim of this study is to investigate whether the extent of resection is an important prognostic factor in carcinoma of the gastric cardia.

METHOD: Records of 60 patients with carcinoma of gastric cardia, operated on between the January 1989-January 1993 at Istanbul University, Cerrahpasa Medical Faculty Department of General Surgery, were reviewed retrospectively. The relationship between clinico-histopathological variables and 5-year survival was retrospectively analysed.

RESULTS: Of the 14 clinico-histopathological variables, eight (age, local invasion, grade, lymphatic micro-invasion, depth of penetration, lymph node involvement, type of operation and stage of disease) were found to have a significant influence on survival. Among those clinico-histopathological variables that influenced 5-year survival on univariate analysis, only age (p = 0.0029) and depth of tumour penetration (p = 0.008) independently affected survival.

CONCLUSION: According to our results, depth of tumour penetration and age are the only variables which were found to independently affect 5-year survival. Depth of tumour penetration may serve as a potential marker for a biologically more aggressive tumour. The extent of resection (TG vs. PG) does not affect the long-term survival of the adenocarcinoma of the cardia.