ADENOCARCINOMA OF THE GASTRIC CARDIA - PROGNOSTIC-SIGNIFICANCE OF PATHOLOGICAL AND TREATMENT FACTORS

The records of 146 patients who had surgery for adenocarcinoma of the gastric cardia between 1977 and 1992 at National Taiwan University Hos pital were retrospectively analyzed. The prognostic significance of pa thologic and surgical treatment factors was examined by log rank test and stepwise regression procedures. The overall 2-year and 5-year surv ival rates were 40.2% and 23.7%, respectively. The pathologic factors analyzed included: age, sex, tumor diameter, esophageal invasion, path ologic grading, vascular invasion, perineural invasion, depth of. inva sion, node-status, distant metastasis and number of positive lymph nod es. The surgical treatment factors analyzed included: surgical procedu re, region of lymphadenectomy, resection margin and resection status. Resection status was classified into three categories: absolute curati ve, relative curative and palliative. Univariate analyses showed that esophageal invasion, vascular invasion, depth of invasion, node status , node number, resection margin and resection status were significant prognostic factors. The selected stepwise regression model identified three significant independent factors: node status, resection status a nd esophageal invasion. Aggressive surgical management, ment, includin g combined resection and extended lymphadenectomy, may be helpful for patients with adenocarcinoma of the gastric cardia.