[Diagnosis and long-term results of surgical resection of early cardiac adenocarcinoma].
OBJECTIVE
To summarize therapeutic experience and the long-term results of early cardiac adenocarcinoma with surgical resection.


METHODS
Ninety cases were diagnosed with early cardiac adenocarcinoma during endoscopic screening in high incidence rate area of esophageal cancer from 1972 to 1997. All of the patients accepted surgical treatment. Cardiectomy included partial stomach and esophagus was performed through left thoracotomy in all patients. Esophagogastrostomy was carried out in the infra-aortic region and thoracoabdominal lymphatic dissection was performed in all cases.


RESULTS
The resection rate was 100%. One patient died in one month after the operation. Postoperative complications occurred in 4 cases (4.4%). Pathological examination of cancer specimens showed that 46 cases (51.1%) were intramucosal carcinoma without lymphatic metastasis and 44 cases (48.9%) were submucous infiltrating carcinoma with lymphatic metastasis in 5 (11.4%). The patients were followed-up to 2002, and the overall 5, 10, 15, 20 and 25 year survival rates were 91.9%, 83.6%, 69.6%, 49.8% and 16.6%, respectively.


CONCLUSIONS
Early diagnosis and early treatment may be the best approach for promoting the survival of the cardiac cancer. Surgical resection of early cardiac carcinoma provides excellent long-term survival.
Wang
Guo-qing
GQ
Department of Thoracic Surgery, Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China. wgq2581@yahoo.com.cn
Jiao
Guang-gen
GG
Song
Jin-xiang
JX
Fang
Wei-hong
WH
Lü
Ning
N
Lin
Dong-mei
DM
Xie
Yong-qiang
YQ
Zhang
Jun-hui
JH
Wei
Wen-qiang
WQ
D000230:Adenocarcinoma / Q000175:diagnosis / Q000601:surgery*; D000328:Adult; D000368:Aged; D002299:Cardia; D055088:Early Detection of Cancer; D016629:Esophagectomy; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome