APPLICATION OF THE NEW CLASSIFICATION FOR CANCER OF THE CARDIA

Background. Cancer of the cardia is now topographically classified int o three types. type I, with the tumor center in the distal esophagus t reated with subtotal esophagectomy; type II; arising at the gastroesop hageal junction and treated with distal esophagectomy and either proxi mal or total gastrectomy and type III, subcardial cancer treated with extended total gastrectomy. Our objective was to review the new classi fications and compare the outcomes in patients grouped and treated acc ording to these classifications. Methods. Seventy-four patients with c ancer of the cardia-15 with type I, 30 with type II, and 29 with type III cancer-underwent surgical resection at our institution between 199 2 and 1997. Postoperative complications, UICC stages, and survival (Ka plan-Meier) were compared. Results. The majority of patients with type I (73%) or type II (53%) cancer had stage I or II tumors, but only 27 % of patients with type III cancer had this tumor stage (P < .05). Ove rall 30-day mortality was 4% and morbidity was 31%. Curative resection s were performed in 73% (54 of 74) of the patients with 3-year surviva l rates of 72% (type I), 68% (type II), and 61% (type III). Conclusion . The recommended therapy for the different types of cancer of the car dia results in acceptable morbidity, mortality, and survival rates.