Survival and surgical outcomes of cardiac cancer of the remnant stomach in comparison with primary cardiac cancer.
BACKGROUND
Although cardiac cancer of the remnant stomach and primary cardiac cancer both occur in the same position, their clinical characteristics and outcomes have not been compared previously. The objective of this study was designed to evaluate the prognosis of cardiac cancer of the remnant stomach in comparison with primary cardiac cancer.


METHODS
In this retrospective comparative study, clinical data and prognosis were compared in 48 patients with cardiac cancer of the remnant stomach and 96 patients with primary cardiac cancer who underwent radical resection from January 1995 to June 2007. Clinicopathologic characteristics, survival times, mortality, and complications were analyzed.


RESULTS
The 5-year survival rate was significantly higher in patients with primary cardiac cancer than in those with cardiac cancer of the remnant stomach (28.4% vs. 16.7%, P = 0.035). Serosal invasion, lymph node metastasis and tumor location were independent prognostic factors for survival. Subgroup analysis, however, showed similar survival rates in patients with primary cardiac cancer and cardiac cancer of the remnant stomach without serosal invasion (25.0% vs. 43.8%, P = 0.214) and without lymph node metastasis (25.0% vs. 38.8%, P = 0.255), as well as similar complication rates (20.8% vs. 11.5%, P = 0.138).


CONCLUSIONS
Although the survival rates after radical resection in patients with cardiac cancer of the remnant stomach were poorer than in those with primary cardiac cancer, they were similar in survival rates when patients without serosal invasion or lymph node metastasis. Therefore, early detection is an important way to improve overall survival in cardiac cancer of the remnant stomach.
Yi
Y
Wang
Department of Gastric Surgery, Fujian Medical University Union Hospital, No, 29 Xinquan Road, Fuzhou 350001, Fujian Province, China. hcmlr2002@163.com.
Chang-Ming
CM
Huang
Jia-Bin
JB
Wang
Chao-Hui
CH
Zheng
Ping
P
Li
Jian-Wei
JW
Xie
Jian-Xian
JX
Lin
Jun
J
Lu
D000230:Adenocarcinoma / Q000401:mortality* / Q000556:secondary / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects*; D018530:Gastric Stump / Q000473:pathology / Q000601:surgery*; D006338:Heart Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000175:diagnosis / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D015996:Survival Rate