title: Carcinoma of the gastric cardia: surgical practices and short-term operative results in a defined Swedish population.
abstract: Adenocarcinoma of the gastric cardia has one of the most rapidly increasing incidence rates of all tumors in Western countries. The aim of this population-based investigation was to study surgical practices and postoperative morbidity and mortality during routine hospital care. The study comprised 176 patients given a new diagnosis of adenocarcinoma of the gastric cardia from February 1, 1989 to the January 31, 1995 in five Swedish counties. The tumor was resectable in 100 (57%) patients (in 36% of the women and 64% of the men), but only 46% of all patients could be offered a potentially curative operation. A total gastrectomy was performed in 54 patients and a proximal gastric resection in 44. Postoperative complications occurred in 39%: in 20% of the patients under age 60 years and in 47% of those aged 60 and over (p = 0.006). Seventeen operated patients (13%) died before discharge. The hospital mortality increased from 3% among those < 60 years of age to 18% among those > 69 years (p = 0.041). Surgical treatment of carcinoma of the gastric cardia carries substantial morbidity and mortality. No important progress seems to have taken place since the 1960s.
authors.affiliation: Department of Surgery, Mora Hospital, S-792 85 Mora, Sweden.
authors.forename: L E
authors.initials: LE
authors.lastname: Hansson
authors.forename: A M
authors.initials: AM
authors.lastname: Ekström
authors.forename: R
authors.initials: R
authors.lastname: BergströmD Sc
authors.forename: O
authors.initials: O
authors.lastname: Nyrén
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002299:Cardia / Q000601:surgery*; D016001:Confidence Intervals; D005260:Female; D005743:Gastrectomy / Q000145:classification; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007813:Laparotomy; D016013:Likelihood Functions; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010166:Palliative Care; D010351:Patient Discharge; D011159:Population Surveillance; D011183:Postoperative Complications; D013274:Stomach Neoplasms / Q000601:surgery*; D015996:Survival Rate; D013548:Sweden; D016896:Treatment Outcome