Comparative studies of cardia carcinoma and infracardial gastric carcinoma

Abstract

In a part retrospective, part prospective study, 354 carcinomas of the cardia were compared with 1259 infracardial gastric carcinomas with regard to the age and sex of the patients, macroscopic classification, microscopic classifications, depth of invasion, and survival rates. Mortality rates are generally higher in cardia carcinoma than in stomach carcinoma. The difference is due to the significantly poorer survival of cardia carcinoma patients in stage I, while mortality rates in stages II, III, and IV of both types are approximately similar. Highly significant differences were also found with regard to sex ratio, incidence of macro- and microscopic subtypes, and invasive growth. The typical cardia carcinoma occurs preferentially in men, is mostly well-delineated, and is manifested as an ulcerated or polypoid, well-differentiated tumor of expansive growth, corresponding to Laurén's intestinal type. These results confirm the concepts of McPeak and Warren, MacDonald, and Siewert et al., that the carcinoma located in the cardia must be seen as a separate entity of gastric carcinoma.

Association of HER2/ErbB2 Expression and Gene Amplification with Pathologic Features and Prognosis in Esophageal Adenocarcinomas

“…Moreover, the frequency of HER2-positivity in the non-metastatic, potentially curative setting has not been adequately studied, yet has substantial clinical relevance, since such knowledge may guide HER2 testing for the identification of patients for HER2 targeted therapy. To date, studies in EAC have been limited by small sample sizes and inclusion of squamous cell carcinomas or subcardial gastric carcinomas whose epidemiology and biology are distinct from EAC (17–19). …”

The gastric mucosa in gastric cancer patients in a low-incidence area

“…All cancers in the cardiac-junctional region were of the intestinal type, as found in a German study [24]. Half of these patients had H. pylori gastritis, and only two had MAG.…”

Proposal for a new definition of true cardia carcinoma

“…Some authors have suggested that cardia carcinomas and adenocarcinomas of the esophagus share to a significantly degree patterns of age, sex distribution, and morphologic characteristics, and that these tumors should be defined as belonging to the same entity [2,4]. Other reports suggest that cardia cancer is a distinct entity independent of subcardia cancer [1,8], and Kim et al found no significant differences in clinicopathological characteristics and protein expressions between Siewert types II and III carcinomas [10]. The prognosis has been reported to be significantly worse in cases of cardia carcinoma than in subcardia carcinomas [1,8,21], although Kim et al found no difference in survival rates between types II and III carcinomas [10].…”

“…Other reports suggest that cardia cancer is a distinct entity independent of subcardia cancer [1,8], and Kim et al found no significant differences in clinicopathological characteristics and protein expressions between Siewert types II and III carcinomas [10]. The prognosis has been reported to be significantly worse in cases of cardia carcinoma than in subcardia carcinomas [1,8,21], although Kim et al found no difference in survival rates between types II and III carcinomas [10]. The present study indicated that a poor prognosis for cardia carcinoma became distinct when type IIA tumors were analyzed separately from type IIB tumors.…”

“…However, it remains controversial whether cardia carcinoma should be categorized and treated as esophageal cancer, gastric cancer, or an independent entity [1][2][3][4][5][6][7][8][9][10]. Although cardia carcinoma is not uniformly defined, the classification of adenocarcinomas of the esophagogastric junction (EGJ) proposed by Siewert et al [11] is used worldwide.…”