[Locally advanced cardia carcinoma--is resection worthwhile?].
Long-term results in 217 patients with carcinoma of the cardia were analysed prospectively. 43 of the 217 could not be operated upon, either because of their poor general condition (51%), distal metastases (49%), and (or) the primary tumour having advanced too far locally (9%). Two of the 176 patients proved to be inoperable at surgery so that only 174 underwent resection (operation rate 81%; resection rate 99%). The operation risk was no higher for advanced tumour (T3/T4) than for earlier tumour stages (T1/T2). The tumour was completely resected macroscopically and microscopically (R0 resection) in 59% of patients in stage T4. Their median survival time was significantly higher than that for patients with local lymph-node spread (12.5 vs 6.0 months; P less than 0.01). Those patients who endoscopically received palliative treatment had a median survival time of 5 months. These results suggest that resection of locally advanced carcinoma of the cardia is worth while, if the tumour can be removed completely both macroscopically and microscopically (R0 resection).
Hölscher
A H
AH
Chirurgische Klinik und Poliklinik, Technische Universität München.
Schüler
M
M
Thorban
S
S
Bollschweiler
E
E
Siewert
J R
JR
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002299:Cardia; D004947:Esophagus / Q000601:surgery; D005260:Female; D005743:Gastrectomy; D005773:Gastroscopy; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*
Das lokal fortgeschrittene Kardiakarzinom--lohnt die Resektion?