[Natural progression of early stage adenocarcinoma of gastric cardia: a report of seventeen cases].
OBJECTIVE
The survival time of untreated advanced gastric cardiac adenocarcinoma patients is about 8-9 months. This study was to observe the natural progression of untreated early stage gastric cardiac adenocarcinoma.


METHODS
In 1987, at a high risk area of esophageal cancer, 851 patients with a previous cytologic diagnosis of esophageal dysplasia were re-examined by endoscopy, and 43 of them were diagnosed histologically as gastric cardiac adenocarcinoma. Of the 43 patients, 31 had early stage tumors, 12 had advanced tumors. The 17 early stage patients who refused treatment were followed up for 14 years till death.


RESULTS
Of the 17 untreated patients, 12 were died of gastric cardiac adenocarcinoma, 5 were died of non-cancer diseases; 13 had survived for over 5 years. The 5-year natural survival rate was 76.47%; the 10-year natural survival rate was 23.53%.


CONCLUSIONS
The progression of early stage cardiac cancer to advanced cancer is a very slow and long process, which is very helpful for early diagnosis and choice of therapeutic timing. The therapeutic effect on early stage cardiac cancer should be assessed with consideration of the natural history of this disease.
Wang
Guo-Qing
GQ
Department of Thoracic Surgery & Epidemiology, Cancer Hospital/Institute of Oncology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100021, PR China. wgq2581@yahoo.com.cn
Wei
Wen-Qiang
WQ
Zhang
Jun-Hui
JH
D000230:Adenocarcinoma / Q000473:pathology*; D000368:Aged; D002278:Carcinoma in Situ / Q000473:pathology; D002299:Cardia / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D013274:Stomach Neoplasms / Q000473:pathology*; D015996:Survival Rate