Clinicopathologic profiles and prognosis of gastric carcinomas from the cardia, fundus/body and antrum

Background/Aims: The putative influence of tumor location on the biologic b ehavior of gastric carcinomas remains controversial. The aim of this study was to investigate if carcinomas arising in the three types of gastric muco sa (cardia, fundus/body and antrum) have different clinical and pathologic profiles and carry a different prognosis. Methods: Three hundred and two pa tients with cardia or gastric carcinoma resected between 1984 and 1996 were retrospectively studied. Cases were divided in three groups according to t umor location: cardia (n = 80); fundus/body (n = 60); antrum (n = 162). The three groups were crosstabulated with clinic and pathologic parameters, su ch as age, sex, macroscopy, histology, desmoplasia, tumor size, depth of tu mor walt penetration, nodal status, venous invasion and stage. Survival rat es were calculated for the three locations according to the aforementioned parameters. Univariate survival analysis and Cox regression were performed for each location. Results: Cases from the cardia and fundus/body were simi lar and distinct from antrum cases according to macroscopy, tumor size, dep th of wall penetration, venous invasion, nodal status and stage. Cases from the cardia cases according to gender and Lauren's classification. An overa ll difference in survival between the three locations was observed (p = 0.0 06). Cumulative survival was better for patients with carcinomas in the ant rum than in the cardia (p = 0.04) and in the fundus/body (p = 0.003); no si gnificant differences were observed in survival between cardia and fundus/b ody carcinoma cases. Cox regression identified stage and venous invasion as prognostic factors for patients with carcinomas in the three locations. In the group of cardia tumors, older patients had a worse outcome and in the group of fundus/body carcinomas, large tumors were associated with a poorer survival. Conclusions: Our results show that cardia carcinoma and antrum c arcinoma are distinct gastric carcinoma entities whereas fundus/body carcin oma shares some characteristics from both entities. Copyright (C) 2001 S. K arger AG, Basel.