Journal of surgical oncology · 1998
Survival of proximal third gastric carcinoma.
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Lardenoye J W, Kappetein A P, Lagaay M B, Allema J H, Breslau P J
Аннотация
BACKGROUND AND OBJECTIVES: Proximal third gastric carcinoma is a distinct clinical entity compared with tumors located in other parts of the stomach with a rapid increasing incidence and a poor prognosis. This study was done to evaluate therapy for, and survival of, patients with gastric cardia carcinoma.
METHODS: Clinical features and prognosis of 49 patients with proximal third gastric carcinoma between 1985 and 1995 (mean age 69.7 years) were evaluated.
RESULTS: In 20 of the 49 patients, laparotomy was excluded because of widespread disease and/or poor clinical condition at presentation. Palliative therapy consisted of gastric tube implantation (n = 4), dilation (n = 3), or radiotherapy (n = 4). In 9 patients, no specific palliative therapy was indicated. Twenty-nine patients underwent laparotomy (59%). In 13 patients, a total gastrectomy with esophagojejunostomy was performed, and in 7 patients a partial gastrectomy was performed. In 9 cases, the tumor was irresectable. In 8 of these 9 patients, a Celestin tube was implanted. Median survival in all patients was 7 months and the expected probability of survival after 50 months was zero. The median survival of patients who underwent a resection was significantly better than in those in whom no resection was performed (23 vs. 4 months, P = 0.047).
CONCLUSIONS: We conclude that long-term survival of patients with proximal third gastric carcinoma is poor. However, long-term survival may be best warranted when patients present at an early stage and resection can be performed.
METHODS: Clinical features and prognosis of 49 patients with proximal third gastric carcinoma between 1985 and 1995 (mean age 69.7 years) were evaluated.
RESULTS: In 20 of the 49 patients, laparotomy was excluded because of widespread disease and/or poor clinical condition at presentation. Palliative therapy consisted of gastric tube implantation (n = 4), dilation (n = 3), or radiotherapy (n = 4). In 9 patients, no specific palliative therapy was indicated. Twenty-nine patients underwent laparotomy (59%). In 13 patients, a total gastrectomy with esophagojejunostomy was performed, and in 7 patients a partial gastrectomy was performed. In 9 cases, the tumor was irresectable. In 8 of these 9 patients, a Celestin tube was implanted. Median survival in all patients was 7 months and the expected probability of survival after 50 months was zero. The median survival of patients who underwent a resection was significantly better than in those in whom no resection was performed (23 vs. 4 months, P = 0.047).
CONCLUSIONS: We conclude that long-term survival of patients with proximal third gastric carcinoma is poor. However, long-term survival may be best warranted when patients present at an early stage and resection can be performed.