Limited Esophagogastrectomy for Carcinoma of the Cardia

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Abstract
Between 1970 and 1988, 149 patients with carcinoma of the cardia were operated on at the Lahey Clinic. Of these patients, 127 (85%) underwent resection; 23 (18.1%) were of a palliative nature. More than 75% had Stage III and IV disease. One patient (0.8%) died within 30 days of the operation of a myocardial infarct. Two other patients failed to leave the hospital. Of 25 postoperative complications, 14 (11%) were considered major. Palliation of dysphagia was successful in 80% of patients. The actuarial 5-year survival rate was 22.4%. Of patients with Stage I and II disease, 36.6% survived for 5 years, and of patients with Stage III disease, 22.5% survived. No patient with Stage IV disease lived for longer than 1 year. It is concluded that limited esophagogastrectomy can be performed in most patients with carcinoma of the cardia with low mortality and morbidity and with satisfactory long-term survival.