[Surgical management of adenocarcinoma of the gastric cardia--experience in 937 patients].

A total of 937 patients with adenocarcinoma of the gastric cardia were operated on within a period of 27 years. The overall resectability rate was 74.5%, the operative mobility was 16.0% and the resection mortality was 1.7% (within 30 days postoperatively). The incidences of anastomotic leakage and pulmonary complications were 3.7% and 3.2%, respectively. These two major complications carried mortality rates of 19.2% and 4.8% and accounted for 50% of the post-operative death. The 1-, 3-, 5-, and 10- year survival rates were 66.9%, 30.0%, 19.5% and 10.3%, respectively. The authors advise regular subtotal proximal gastrectomy when the cancer is confined to the stomach only or extends distally within one third of the lesser curvature. The main factors influencing the long-term results are lymph node metastasis, carcinomatous invasion to gastric serosa and the type of resection, either palliative or curative.