Clinicopathologic Features of Adenocarcinoma at the Gastric Cardia: Is it Different from Distal Cancer of the Stomach?

Maeda, Hiromichi; Okabayashi, Takehiro; Nishimori, Isao; Sugimoto, Takeki; Namikawa, Tsutomu; Dabanaka, Ken; Tsujii, Shigehiro; Onishi, Saburo; Kobayashi, Mariko; Hanazaki, Kazuhiro

doi:10.1016/j.jamcollsurg.2007.06.306

Cited by 51 publications

(48 citation statements)

References 31 publications

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“…The significant factor is the origin from GEJ, a site which shares the mentioned probabilities of delayed diagnosis and advanced stage at presentation, of wide pre-clinical spread and consequently more complex surgical needs. This concept substantially agrees with the conclusions of Jin et al (15) and of Maeda et al (16), but further confirmation is required.…”

Section: Discussionsupporting

confidence: 90%

Tumors of the gastroesophageal junction have intermediate prognosis compared to tumors of the esophagus and stomach, but share the same clinical determinants

et al. 2011

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Abstract. The issue of whether carcinoma of the gastroesophageal junction (GEJ) should be considered a distal esophageal, a proximal gastric or an independent tumor, at least with regards to clinical evaluation and management remains controversial. This study included 613 retrospective consecutive patients with carcinoma of the upper digestive tract, 64 of the esophagus, 58 of the GEJ and 491 of the stomach. The prognostic impact of the main clinical and histological parameters was analyzed in relation to relative survival as an estimate of the excess mortality. Relative survival and standardized mortality ratio (SMR) were calculated from the observed survival and the expected survival of the general population with identical age, gender and calendar years of observation. Multivariate analyses were applied to the proportional hazards model of the relative survival. The excess mortality, expressed by the relative survival and SMR of the patients with GEJ carcinoma are intermediate compared to those of patients with esophageal and gastric tumors. However, prognosis is not determined by tumor location, histology or administration of adjuvant chemotherapy, but mainly by stage and radical surgical resection. Gender has a minor but significant prognostic effect and age showed a slight inverse correlation with excess mortality. In conclusion, the excess mortality related to the tumors of the upper digestive tract is determined by stage, radical resection, gender and age. The intermediate prognosis of GEJ tumors mainly depends on a particular combination of such elementary determinants. IntroductionTopics such as the pathogenesis, clinical evaluation and treatment of tumors of the gastroesophageal junction (GEJ) are a controversial issue. This matter is likely due to the lower incidence of these tumors as compared to that of cancers of the esophagus or stomach, and to the fact that in clinical trials such tumors have been never treated as a distinct disease entity, but are generally grouped together with either esophageal or gastric cancers. Therefore, whether cancers of the esophagus, GEJ and stomach are a single disease, two diseases or more remains to be clarified (1).In western countries, there is a trend to an increasing incidence of esophageal cancers as more of them are distal and of gastric cancers as more of them are proximal (2). In accordance with this epidemiologic shift of the carcinomas of contiguous digestive sections, the incidence of GEJ tumors was reported to have increased by 5-fold over the last 20 years of the previous century (3). A recent worldwide overview documented a roughly homogeneous and steady incidence of cardia cancers since 1980, despite the declining incidence of other non-cardia carcinomas (4). However, the identification of GEJ does not rely on universally accepted criteria (5,6). Staging classification varies for esophageal and gastric cancers and it is uncertain which staging is more appropriate for GEJ cancers. Appropriate staging is crucial since the clinical presentation of GEJ t...

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Section: Discussionsupporting

confidence: 90%

Tumors of the gastroesophageal junction have intermediate prognosis compared to tumors of the esophagus and stomach, but share the same clinical determinants

et al. 2011

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“…Among Caucasians, the results were similar. Noncardia gastric cancer is different from cardia gastric cancer in both clinical and pathologic features [38,39]. H. pylori infection is known to be associated with noncardia gastric cancer [40,41].…”

Section: Discussionmentioning

confidence: 99%

Aspirin Use and the Risk of Gastric Cancer: A Meta-Analysis

et al. 2009

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“…In contrast to the rapidly rising incidence of adenocarcinoma of the gastric cardia in the West [1,2], the disease is still rare in the East [3,4]. Moreover, the distal third of the stomach remains as the favored site of gastric adenocarcinoma in Korea [5].…”

Section: Introductionmentioning

confidence: 99%

Clinical significance of gastric outlet obstruction on the oncologic and surgical outcomes of radical surgery for carcinoma of the distal stomach

Park

Mok

Kim

et al. 2009

Journal of Surgical Oncology

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Clinicopathologic Features of Adenocarcinoma at the Gastric Cardia: Is it Different from Distal Cancer of the Stomach?

Cited by 51 publications

References 31 publications

Tumors of the gastroesophageal junction have intermediate prognosis compared to tumors of the esophagus and stomach, but share the same clinical determinants

Tumors of the gastroesophageal junction have intermediate prognosis compared to tumors of the esophagus and stomach, but share the same clinical determinants

Aspirin Use and the Risk of Gastric Cancer: A Meta-Analysis

Clinical significance of gastric outlet obstruction on the oncologic and surgical outcomes of radical surgery for carcinoma of the distal stomach

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