Clinicopathological Study of Early Cancer of the Cardia

Kikuo Koufuji, Jinryo Takeda, Keishirou Aoyagi, Shojirou Yano, Naotaka Murakami, Susumu Sueyosi, Hideaki Yamana, Hiromasa Fujita and Kazuo Shirouzu

Department of Surgery, Kurume University School of Medicine

Between 1980 and 1999, 27 cases of early cancer of the cardia occurring within 2 cm of the esophagogastric junction and 99 cases of non-cardiac early cancer of the proximal portion of the stomach were treated by surgical resection in our department. The 27 cases of early cancer of the cardia were compared with 99 cases of the non-cardiac cancer in terms of gender, mean age, tumor size, gross appearance, histologic appearance, depth of invasion, lymph node involvement and esophageal hiatus hernias. Adenocarcinoma of the esophagus was also assessed. Average age and the incidence of elevated-type lesions macroscopically and differentiated-type lesions histologically were significantly higher in early cancer of the cardia than in non-cardiac cancer (p<0.05). Nine of the 27 cases of early cancer of the cardia and 12 of the 99 cases of non-cardiac cancer were accompanied by esophageal hiatal hernia. The incidence were significantly higher in early cancer of the cardia than in non-cardiac cancer (p<0.05). By contrast, there were no significant differences in gender, tumor size, depth of invasion, or lymph node involvement between the two groups. Adenocarcinoma of the esophagus was found in 3 cases, and 2 of them were originated from Barrett esophagus and 1 from heterotopic gastric mucosa. Since early cancers of the cardia were often located in esophageal hiatal hernias, it is important to examine the esophageal hiatal hernias carefully endoscopically.

Key words
early cardiac cancer, Barrett esophagus, esophageal hiatal hernia, adenocarcinoma of the esophagus

Reprint requests
Kikuo Koufuji Department of Surgery, Kurume University School of Medicine 67 Asahi-machi, Kurume-city, 830-0011 JAPAN

Accepted
February 28, 2001

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