Is cardia cancer a special type of gastric cancer? A differential analysis of early cardia cancer and non-cardia cancer

Abstract

Background: The prognosis of early cardia cancer and non-cardia cancer is still controversial. It is difficult to collect a large number of cases with complete information in clinical practice. Our study was aimed to identify the differences in clinicopathological characteristics and outcomes of early cardia gastric cancer and non-cardia gastric cancer. Methods: All cases analyzed were from Surveillance, Epidemiology, and End Results database. The data of the patients with early gastric cancer from 2004 to 2010 was retrospectively analyzed. Patients were distributed to cardia cancer group and non-cardia cancer group. Univariate and multivariate analyses were performed to examine differences between groups. The competitive risk model was made to compare the association with cardia cancer and non-cardia cancer about the causes of death. Propensity score matching (PSM) was performed to reduce the bias. Results: We found that cardia cancer was more common in male patients and the White than that in non-cardia cancer at early stage, signet ring cell carcinoma was more common in non-cardia cancer, and the differentiation of non-cardia cancer was worse. Univariate analysis showed that age, marital status, race, tumor location, histology, grade, stage, and operation or not can determine the prognosis. And the prognosis of patients with cardia cancer was worse than that of non-cardia cancer, according to lymph node metastasis and the depth of tumor invasion. Multivariate analysis showed cardia cancer was an independent prognostic factor for poor prognosis. After PSM, cardia cancer still exhibited poor prognosis. Conclusions: At early stage, cardia cancer had a poor prognosis compared with non-cardia cancer. The prevention and treatment of early cardia cancer need to be seriously treated.

Survival trends in gastric cancer patients between 1987 and 2016: a population-based cohort study in Finland

“…Gastric non-cardia and cardia cancers exhibit differences in their etiology, incidence, and prognosis [2][3][4]. The incidence of gastric cardia cancer is increasing along with increasing obesity and reflux, while non-cardia cancer incidence is decreasing due to the lower prevalence of Helicobacter pylori infection [5][6][7]. Prevention of colonization of H. pylori has shown a potential to reduce incidences of gastric cancer [3,8], but the best curative treatment for gastric cancer patients includes early diagnosis and surgical resection [9].…”

The Number of Positive Tumor Markers (NPTM) Achieves Higher Value in the Prognosis Prediction of Gastric Cancer

“…However, the survival of GC patients at the same disease stage might be heterogeneous [5]. Many other factors such as age, gender, tumor size, tumor location, inflammatory factors, and tumor markers not involved in AJCC staging system might affect the outcomes of GC as well [6][7][8][9][10]. Thus, by integrating these important factors, the individual prognosis of GC patients could be better assessed.…”

Modern endoscopy in the diagnosis of early esophago-gastric junction cancer

“…Проблема своевременной диагностики и лечения КЭР (К ЭР) является одной из важных в современной онкологии. Это обусловлено как значительными показателями заболеваемости населения новообразованиями этой локализации, так и высоким уровнем запущенности, обуславливающим значимые уровни смертности [1,2,3]. Так, по данным National Comprehensive Cancer Network (NCCN), более чем у 50% больных кардиоэзофагеальным раком на этапе первичного обследования обнаруживаются отдаленные метастазы и менее чем 60% пациентов с местно-распространенными опухолями данной локализации являются операбельными [4].…”

“…Безусловно, выявление КЭР на ранней стадии опухолевого процесса, когда возможно выполнить радикальное малоинвазивное внутрипросветное эндоскопическое лечение, помогло бы избежать таких исходов [15,16,17,18], однако, по данным большинства исследований [1,19,20], ранний КЭР выявляется крайне редко. Более того, до настоящего времени ни в одной из опубликованных работ не представлено данных об истинной частоте встречаемости I стадии КЭР.…”

“…Это имеет принципиальное значение, так как, по данным многих авторов не-кишечный типа рака субкардиального отдела желудка, даже на ранней стадии опухолевого процесса имеет значительно худший прогноз, нежели чем КЭР, а рак на фоне пищевода Барретта требует принципиально других подходов к эндоскопическому лечению. Так, известно, что ранний рак субкардиального отдела желудка намного чаще распространяется на подслизистый слой стенки и характеризуется более быстрым регионарным метастазированием [1,37].…”