Comparison of esophagocardiac and more distal gastric cancer in patients with prior ulcer surgery.

BACKGROUND

Adenocarcinoma of the gastric cardia and/or lower esophagus differs from cancer of the more distal stomach.

METHODS

The authors compared the proportion of patients with these two types of cancer who underwent surgery for peptic ulcers more than 5 years before the diagnosis of cancer during the periods 1977-82 and 1983-88.

RESULTS

The total number of patients with esophagocardiac cancer increased from 99-241 between the two periods, but the number with previous ulcer surgery remained the same (n = 7) in each period. The total number of more distal gastric cancers decreased from 262 to 237 between the two periods, but the number with previous ulcer surgery increased from 9-26 (P = 0.002). Only 4 of 14 patients with esophagocardiac cancer and a previous ulcer had a partial gastrectomy compared with 27 of 35 patients with more distal gastric cancers (P = 0.005).

CONCLUSION

These data indicate a relationship between partial gastrectomy and the late development of gastric cancer, but this finding is confined to cancers not involving the cardia.