[Surgical treatment of cancer of the cardia]

Abstract

Adeno-carcinoma of the cardia corresponds to an accurate definition. During a period of 20 years we have operated on 114 such tumours, and resected 88 of them, 44 by esophageal and proximal gastric resection (group I), and 44 by esophageal and total gastric resection (group II). The resection rate was 77%. Hospital mortality was 20 p. cent in group I and 27 p. cent in group II. There were 1 T1, 8 T2 and 77 T3 (on 86 specimens); 14 p. cent of tumour invasions were observed on the esophageal section (18 p. cent in group I, 9 p. cent in group II); 90 p. cent had lymphatic nodes invasion. Five year's survival was nil in group I, 5 patients survived in group II. Five year's cure can be obtained only in stages I et II (NO MO or NI MO) with total gastrectomy associated with omentectomy, lymphatic curettage of the three coeliac chains, resection of 8 cm of esophagus, and mediastinal lymphatic curettage. When the condition of the patient is poor, or for more evolved stages, proximal gastric resection associated with terminal esophagectomy is the best palliative treatment.