We have located links that may give you full text access.
Survival of patients with distal esophageal and gastric cardia tumors: a population-based analysis of gastroesophageal junction carcinomas.
Journal of Thoracic and Cardiovascular Surgery 2010 January
OBJECTIVE: Distal esophageal tumors and gastric cardia tumors, although only physically separated by centimeters, have different staging systems and are usually treated differently. We hypothesized that gastroesophageal junction adenocarcinomas (eg, gastric cardia and distal esophageal tumors) were not distinct entities and had similar survival.
METHODS: Using the Surveillance, Epidemiology, and End Results database (1988-2005), we identified patients with adenocarcinomas of the distal esophagus (n = 1474) and gastric cardia (n = 192). We performed an unadjusted survival analysis using the Kaplan-Meier method, and we used a Cox proportional hazards regression model to adjust for potential confounding covariates. A 2-sided significance level was used for all statistical testing.
RESULTS: Even after adjusting for potential confounding covariates (location, stage, race, cancer-directed surgery, and radiation therapy), we found no significant difference between distal esophageal and gastric cardia tumors with regard to overall (hazard ratio, 1.18; 95% confidence interval, 0.99-1.41) and cancer-specific (hazard ratio, 1.09; 95% confidence interval, 0.90-1.31) survival. Both cancer-directed surgery (hazard ratio, 0.45; 95% confidence interval, 0.37-0.54) and radiation therapy (hazard ratio, 0.63; 95% confidence interval, 0.55-0.71) had a beneficial influence on survival.
CONCLUSION: Through a large, population-based analysis of gastric cardia and distal esophageal adenocarcinomas, we found that patients with gastroesophageal junction adenocarcinomas have similar survival rates. Cancer-directed surgery was beneficial. Adenocarcinomas of the gastroesophageal junction are not distinct entities delineated by anatomic boundaries and as such should be managed by one skilled in both esophageal and gastric resections.
METHODS: Using the Surveillance, Epidemiology, and End Results database (1988-2005), we identified patients with adenocarcinomas of the distal esophagus (n = 1474) and gastric cardia (n = 192). We performed an unadjusted survival analysis using the Kaplan-Meier method, and we used a Cox proportional hazards regression model to adjust for potential confounding covariates. A 2-sided significance level was used for all statistical testing.
RESULTS: Even after adjusting for potential confounding covariates (location, stage, race, cancer-directed surgery, and radiation therapy), we found no significant difference between distal esophageal and gastric cardia tumors with regard to overall (hazard ratio, 1.18; 95% confidence interval, 0.99-1.41) and cancer-specific (hazard ratio, 1.09; 95% confidence interval, 0.90-1.31) survival. Both cancer-directed surgery (hazard ratio, 0.45; 95% confidence interval, 0.37-0.54) and radiation therapy (hazard ratio, 0.63; 95% confidence interval, 0.55-0.71) had a beneficial influence on survival.
CONCLUSION: Through a large, population-based analysis of gastric cardia and distal esophageal adenocarcinomas, we found that patients with gastroesophageal junction adenocarcinomas have similar survival rates. Cancer-directed surgery was beneficial. Adenocarcinomas of the gastroesophageal junction are not distinct entities delineated by anatomic boundaries and as such should be managed by one skilled in both esophageal and gastric resections.
Full text links
Related Resources
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app