CLINICOPATHOLOGICAL FEATURES OF GASTRIC-CANCER INFILTRATING THE LOWERESOPHAGUS

A total of 211 patients with gastric cancer in the upper third of the stomach were clinicopathologically evaluated. Of the 211 patients, 82 had esophageal infiltration and 129 did not. These two groups were com pared. The study on patients who had undergone resection and radioisot ope (Tc-99m-phytate) uptake testing revealed that it was important to dissect the lymph nodes (predominantly nodes 7, 9, 11, and 16) during surgery in the patients with gastric cancer plus esophageal infiltrati on. When cancer infiltration of the esophagus exceeds 1 cm, the prefer red surgical procedure is lower esophagectomy and total gastrectomy wi th abdominal and intrathoracic lymphadenectomy via the left thoracoabd ominal approach. When residual cancer is suggested in the more proxima l esophageal stump due to intramural metastasis from vascular invasion , rapid pathologic diagnosis should be made by frozen sections during surgery and then subtotal esophagectomy by blunt removal of the esopha gus proximally from the aortic arch using a left thoracotomy considere d.