Journal of Clinical Oncology, Vol 15, 2015-2021, Copyright © 1997 by American Society of Clinical Oncology
Prognostic factors in adenocarcinoma of the gastric cardia: pathologic stage analysis and multivariate regression analysis
Y Kajiyama, M Tsurumaru, H Udagawa, K Tsutsumi, Y Kinoshita, M Ueno and H Akiyama
Department of Surgery, Toranomon Hospital, Tokyo, Japan. QZR02725@niftyserve.or.jp
PURPOSE: To clarify the pathologic stages of adenocarcinoma of the gastric
cardia in which the prognosis is worse than in adenocarcinoma of the middle
or distal part of the stomach, and to determine prognostic factors in these
stages by multivariate analysis. PATIENTS AND METHODS: We analyzed 2,536
cases of surgically resected gastric adenocarcinoma of all pathologic
stages. Four hundred seventy-two cases of gastric carcinoma, in which
cumulative survival of gastric cardia was poor, were subjected to Cox
regression analysis for prognostic factors, and to logistic regression
analysis for factors influencing venous or lymphatic invasion. RESULTS: The
prognosis of adenocarcinoma of the gastric cardia was inferior when
compared with similarly staged carcinomas of the middle or lower part of
the stomach when there was invasion of proper muscle layer or subserosal
layer, with no lymph node metastasis or with only adjacent (group 1) lymph
nodes metastases (T2N0 or T2N1, according to the Japanese classification).
In these stages, the prognostic factors were age, histologic type, venous
invasion, and location of the tumor in the upper part of the stomach. Tumor
location in the upper stomach was also a predictor for the presence of
venous invasion. CONCLUSION: The prognosis of adenocarcinoma of the gastric
cardia is poor in patients with T2 tumors with no or few lymph node
metastases. Additional treatment after surgery may be necessary to improve
the survival of this population.
