title: Surgical management of adenocarcinoma of the cardia.
abstract: BACKGROUND
  The incidence of adenocarcinoma of the cardia is increasing. The surgical management remains controversial. The present study reviews our experience with surgically resected adenocarcinoma of the cardia.
  
  
  METHODS
  A retrospective review of 153 cases of surgically resected adenocarcinoma of the cardia was performed. Preoperative radiotherapy was used in 31 patients. The surgical approach, morbidity, mortality, impact of preoperative radiotherapy, and survival were determined.
  
  
  RESULTS
  The type of resection performed was a transhiatal esophagogastrectomy in 78%, a transthoracic esophagogastrectomy in 21%, and a transabdominal esophagogastrectomy in 1%. The in-hospital mortality rate was 4%. The frequency of complications was not associated with the use of preoperative radiotherapy or surgical approach. The 1-year (61%), 2-year (38%), 3-year (23%), and 5-year (16%) survival were not affected by the use of preoperative radiotherapy or surgical approach. Survival was significantly associated with stage and the presence of lymph node metastasis.
  
  
  CONCLUSIONS
  Adenocarcinoma of the cardia is associated with a poor long-term prognosis. The long-term survival does not appear to be affected by the use of preoperative radiotherapy or by surgical approach.
authors.affiliation: Division of Thoracic Surgery, University of British Columbia, Vancouver Hospital & Health Sciences Centre, Canada.
authors.forename: A J
authors.initials: AJ
authors.lastname: Graham
authors.forename: R J
authors.initials: RJ
authors.lastname: Finley
authors.forename: J C
authors.initials: JC
authors.lastname: Clifton
authors.forename: K G
authors.initials: KG
authors.lastname: Evans
authors.forename: G
authors.initials: G
authors.lastname: Fradet
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada / Q000453:epidemiology; D002299:Cardia / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011300:Preoperative Care; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D015996:Survival Rate