title: Clinicopathologic features of adenocarcinoma at the gastric cardia: is it different from distal cancer of the stomach?
abstract: BACKGROUND
  Although the incidence of gastric cardia cancer is considerably less than more distal gastric cancer, the rate of occurrence is now increasing. The objective of this study was to evaluate and compare the clinicopathologic findings of gastric cardia and more distal stomach adenocarcinoma.
  
  
  METHODS
  Patients included in our study were those who underwent operations for gastric adenocarcinoma in our institute from 1981 to 2006, and who had undergone complete medical history, including history of daily alcohol consumption; smoking; body mass index; and pathologic examinations. A total of 843 patients were included in our study, and were divided into cardia and noncardia cancer groups.
  
  
  RESULTS
  Among the 843 patients, 23 (2.8%) had gastric cardia cancer. There were no substantial differences in age, gender, body mass index, smoking, or alcohol consumption between the two groups. Mean size of cardia tumors was larger than noncardia tumors. Although noncardia cancer was often detected at an early stage, gastric cardia cancer was most often diagnosed at an advanced stage. Pathologically, cardia cancer was more invasive and had more lymphatic permeation and lymph node metastasis than noncardia cancer.
  
  
  CONCLUSIONS
  Gastric cardia cancer occurs at a low incidence of only 2.8% of resected gastric cancers. Unlike cases of gastric cardia cancer in Western populations, body mass index is not associated with occurrence of gastric cardia cancer in our study. Because gastric cardia cancer appears more aggressive than noncardia gastric cancer, early diagnosis and intervention are important.
authors.affiliation: Department of Surgery, Kochi Medical School, Kochi, Japan.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Maeda
authors.forename: Takehiro
authors.initials: T
authors.lastname: Okabayashi
authors.forename: Isao
authors.initials: I
authors.lastname: Nishimori
authors.forename: Takeki
authors.initials: T
authors.lastname: Sugimoto
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Namikawa
authors.forename: Ken
authors.initials: K
authors.lastname: Dabanaka
authors.forename: Shigehiro
authors.initials: S
authors.lastname: Tsujii
authors.forename: Saburo
authors.initials: S
authors.lastname: Onishi
authors.forename: Michiya
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hanazaki
mesh_terms: D000230:Adenocarcinoma / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D000368:Aged; D000428:Alcohol Drinking; D015992:Body Mass Index; D002299:Cardia / Q000473:pathology* / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007564:Japan; D008019:Life Style; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking; D013274:Stomach Neoplasms / Q000209:etiology / Q000473:pathology* / Q000601:surgery