title: Clinicopathological features and prognosis of gastric cardia adenocarcinoma: a multi-institutional US study.
abstract: OBJECTIVE
  Potential differences in presentation and outcome of patients with gastric cardia adenocarcinoma (GCA) and non-cardia adenocarcinoma may exist. The aim of the present study was to compare the clinicopathological characteristics and the prognosis of GCA versus non-cardia adenocarcinoma.
  
  
  METHODS
  Patients with gastric adenocarcinoma who underwent gastric resection between 2000-2012 were identified. Clinicopathological characteristics and outcomes were analyzed based on tumor site using a 1:2 matched-control, as well as a multivariable Cox model.
  
  
  RESULTS
  Among 743 patients, 80 (10.7%) patients were diagnosed with GCA. Patients with GCA were more likely to have intestinal tumor type (GCA: 80.4% versus non-cardia: 64.2%, P = 0.04) or advanced AJCC T stage tumors (GCA 71.8% versus non-cardia 59.2%, P = 0.03). GCA patients more likely underwent a total gastrectomy (GCA: 85.7% vs. non-cardia: 39.8%) and had a longer length-of-stay (GCA: 10 days vs. non-cardia: 8 days) (both P < 0.05). Outcomes in early stage I patients were worse among GCA (disease-free survival, 44.2%; overall survival, 42.3%) versus non-GCA (disease-free survival, 60.8%; overall survival, 63.0%) patients(both P < 0.05).
  
  
  CONCLUSIONS
  In general, disease-free survival and overall survival were similar between patients with GCA versus non-cardia adenocarcinoma. However, long-term outcome was worse among patients with GCA and early stage disease.
authors.affiliation: Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Neda
authors.initials: N
authors.lastname: Amini
authors.forename: Gaya
authors.initials: G
authors.lastname: Spolverato
authors.forename: Yuhree
authors.initials: Y
authors.lastname: Kim
authors.forename: Malcolm H
authors.initials: MH
authors.lastname: Squires
authors.forename: George A
authors.initials: GA
authors.lastname: Poultsides
authors.forename: Ryan
authors.initials: R
authors.lastname: Fields
authors.forename: Carl
authors.initials: C
authors.lastname: Schmidt
authors.forename: Sharon M
authors.initials: SM
authors.lastname: Weber
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Votanopoulos
authors.forename: Shishir K
authors.initials: SK
authors.lastname: Maithel
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Pawlik
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D000368:Aged; D002299:Cardia / Q000473:pathology* / Q000601:surgery; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate; D014481:United States / Q000453:epidemiology
keywords: gastric adenocarcinoma; gastric cardia cancer; outcomes; surgery