Adenocarcinoma of the gastric cardia. Focusing on the extent of lymphadenectomy and esophageal resection

Different surgical approaches have been applied to tumors located at the gastric cardia. We performed extended gastrectomy and radical lymphadenectomy in eligible cases of adenocarcinoma of the gastric cardia through an abdominal approach since 1989. The distal esophagus and lower mediastinal lymph nodes can be easily accessed throng an enlarged hiatus. Abdominal nodal metastasis occurred in 76.6% of the patients, and none of the patient developed esophageal recurrence. An overall cumulative 5-year survival rate of 38.0% after operation was observed.