HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hsu, C.-P. Articles by Wang, P.-Y. Search for Related Content PubMed PubMed Citation Articles by Hsu, C.-P. Articles by Wang, P.-Y.

J Thorac Cardiovasc Surg 1997;114:544-551
© 1997 Mosby, Inc.

GENERAL THORACIC SURGERY

CLINICAL EXPERIENCE IN RADICAL LYMPHADENECTOMY FOR ADENOCARCINOMA OF THE GASTRIC CARDIA

Received for publication July 9, 1996 revisions requested Nov. 18, 1996; revisions received May 6, 1997 accepted for publication May 22, 1997. Address for reprints: Chung-Ping Hsu, MD, Division of Thoracic Surgery, Department of Surgery, Taichung Veterans General Hospital, #160, Sec 3, Taichung-Kang Rd., Taichung, Taiwan, Republic of China.

Abstract

Objectives: We evaluated the pattern of nodal metastasis and its prognosis after radical lymphadenectomy in adenocarcinoma of the gastric cardia. Methods: We conducted a retrospective cohort study of 70 patients (52 men and 18 women; mean age 63.6 years) with adenocarcinomas of the gastric cardia who underwent extended gastrectomy (65 total gastrectomies and 5 proximal gastrectomies) and radical lymphadenectomy (D2 to D4) at Taichung Veterans General Hospital between 1989 and 1995. Results: Twenty-four complications developed in 22 (31.4%) patients, and seven (10.0%) hospital deaths occurred. An overall 5-year cumulative survival of 37.6% was obtained. Lymph node metastases were identified in 53 (75.7%) patients. Nodal involvement was closely related to the depth of tumor invasion ( p = 0.005). When the gastric wall invasion was limited to the subserosal layer (T1 and T2, n = 15), no patient had N4 group nodal metastasis. Once the serosal layer had been involved (beyond T3), N4 group nodal metastasis was frequently seen (30.9%, 17 of 55 patients). A multivariable analysis revealed that the level of nodal involvement, the depth of tumor invasion, and the presence of complications were independent prognostic factors. Cumulative 5-year survivals of curability A ( n = 12), B ( n = 19), and C ( n = 32) resections were 100%, 21.2%, and 27.5%, respectively ( p = 0.0001). The long-term survival of the patients after resection was also closely related to their pTNM stages ( p = 0.0004). Conclusions: We conclude that gastrectomy accompanied by radical lymphadenectomy provides a reasonable long-term survival expectancy that is closely related to the stage of the disease and the curability of resection.

This article has been cited by other articles:

				C. Pedrazzani, G. de Manzoni, D. Marrelli, S. Giacopuzzi, G. Corso, A. M. Minicozzi, B. Rampone, and F. Roviello Lymph node involvement in advanced gastroesophageal junction adenocarcinoma J. Thorac. Cardiovasc. Surg., August 1, 2007; 134(2): 378 - 385. [Abstract] [Full Text] [PDF]

				G. de Manzoni, C. Pedrazzani, F. Pasini, A. Di Leo, E. Durante, G. Castaldini, and C. Cordiano Results of surgical treatment of adenocarcinoma of the gastric cardia Ann. Thorac. Surg., April 1, 2002; 73(4): 1035 - 1040. [Abstract] [Full Text] [PDF]

				C.-P. Hsu, C.-Y. Chen, J.-Y. Hsia, and S.-E. Shai Prediction of prognosis by the extent of lymph node involvement in squamous cell carcinoma of the thoracic esophagus Eur. J. Cardiothorac. Surg., January 1, 2001; 19(1): 10 - 13. [Abstract] [Full Text] [PDF]