SURVIVAL OF PROXIMAL 3RD GASTRIC-CARCINOMA

Background and Objectives: Proximal third gastric carcinoma is a disti nct clinical entity compared with tumors located in other parts of the stomach with a rapid increasing incidence and a poor prognosis. This study was done to evaluate therapy for, and survival of, patients with gastric cardia carcinoma. Methods: Clinical features and prognosis of 49 patients with proximal third gastric carcinoma between 1985 and 19 95 (mean age 69.7 years) were evaluated. Results: In 20 of the 49 pati ents, laparotomy was excluded because of widespread disease and/or poo r clinical condition at presentation. Palliative therapy consisted of gastric tube implantation (n = 4), dilation (n = 3), or radiotherapy ( n = 4). In 9 patients, no specific palliative therapy was indicated. T wenty-nine patients underwent laparotomy (59%). In 13 patients, a tota l gastrectomy with esophagojejunostomy was performed, and in 7 patient s a partial gastrectomy was performed. In 9 cases, the tumor was irres ectable. In 8 of these 9 patients, a Celestin tube was implanted. Medi an survival in all patients was 7 months and the expected probability of survival after 50 months was zero. The median survival of patients who underwent a resection was significantly better than in those in wh om no resection was performed (23 vs. 4 months, P = 0.047).Conclusions : We conclude that long-term survival of patients with proximal third gastric carcinoma is poor. However, long-term survival may be best war ranted when patients present at an early stage and resection can be pe rformed. (C) 1998 Wiley-Liss, Inc.