Clinical outcomes of gastric cardia cancer during a recent decade of Korea.

Abstract

87 Background: To date, the incidence of adenocarcinomas of the gastric cardia has been increasing worldwidely. In 7th edition of the American Joint Commission on Cancer, a tumor within 5 cm of the EGJ is classified and staged according to the esophageal cancer. There are two different etiologies of gastric cardia cancer - Barrett's esophagus and Helicobacter pylori (H. pylori) associated intestinal metaplasia. We aimed to evaluate the clinical characteristics and outcome between gastric cardia and non-cardia cancer. Methods: We performed a retrospective cohort study of 90 patients with gastric cardia cancer from Jan. 2003 to Dec. 2013. We selected 180 patients with gastric non-cardia cancer as age and sex matched control during the same period (by AGE, SEX PROGRAM). Results: The rate of curative resection (R0) was significantly low in gastric cardia cancer (74/81 vs. 146/149) (91.4% vs 98.0%, P=.02) The recurrence rate was lower in patents with non-cardia cancer than those with cardia cancer (21/74 vs. 12/146) (28.4% vs 8.0%, P=.00). Subgroup analysis was done for patients with cardia cancer according to BMI and helicobacter infection and atrophic mucosal change. The median follow up period of obese patients and non-obese patients were 35.0month and 28.0month, which revealed there was no difference (P=.70). We determined patients with mucosal atrophic change and HP infection as a group1, and patients with no mucosal change with non- infective status as a group 2. The median follow up period of group 1 patient and group 2 patients were 26.0month and 36.0month, there was no significant difference. (P=.96). Conclusions: Gastric cardia cancer had a negative prognostic impact, compared with gastric non-cardia cancer. Although a possible heterogeneity in the pathogenesis and biological behavior of gastric cardia cancer would be present, there was no difference in prognosis.