Key result
Remnant gastric cardiac cancer linked to ~41% lower 5-year survival vs primary cardiac cancer.
Why the study?
The clinical characteristics and outcomes of cardiac cancer of the remnant stomach and primary cardiac cancer have not been previously compared.
Does cardiac cancer of the remnant stomach have a worse prognosis compared to primary cardiac cancer after radical resection?
Cohort (n=144)
No
Does cardiac cancer of the remnant stomach have a worse prognosis compared to primary cardiac cancer after radical resection?
Absolute Event Rate: 16.7% vs 28.4%
p-value: p=0.035
Patients with cardiac cancer of the remnant stomach have poorer overall survival compared to those with primary cardiac cancer, though survival is similar if detected early without serosal invasion or lymph node metastasis.
Remnant gastric cardia cancer shows poorer post-resection survival; leaves open whether early-stage equivalence holds in larger prospective cohorts.
BACKGROUND: Although cardiac cancer of the remnant stomach and primary cardiac cancer both occur in the same position, their clinical characteristics and outcomes have not been compared previously. The objective of this study was designed to evaluate the prognosis of cardiac cancer of the remnant stomach in comparison with primary cardiac cancer. METHODS: In this retrospective comparative study, clinical data and prognosis were compared in 48 patients with cardiac cancer of the remnant stomach and 96 patients with primary cardiac cancer who underwent radical resection from January 1995 to June 2007. Clinicopathologic characteristics, survival times, mortality, and complications were analyzed. RESULTS: The 5-year survival rate was significantly higher in patients with primary cardiac cancer than in those with cardiac cancer of the remnant stomach (28.4% vs. 16.7%, P = 0.035). Serosal invasion, lymph node metastasis and tumor location were independent prognostic factors for survival. Subgroup analysis, however, showed similar survival rates in patients with primary cardiac cancer and cardiac cancer of the remnant stomach without serosal invasion (25.0% vs. 43.8%, P = 0.214) and without lymph node metastasis (25.0% vs. 38.8%, P = 0.255), as well as similar complication rates (20.8% vs. 11.5%, P = 0.138). CONCLUSION: Although the survival rates after radical resection in patients with cardiac cancer of the remnant stomach were poorer than in those with primary cardiac cancer, they were similar in survival rates when patients without serosal invasion or lymph node metastasis. Therefore, early detection is an important way to improve overall survival in cardiac cancer of the remnant stomach.
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Wang et al. (2014) conducted a cohort in Cardiac cancer of the remnant stomach and primary cardiac cancer (n=144). Cardiac cancer of the remnant stomach vs. Primary cardiac cancer was evaluated on 5-year survival rate (p=0.035). Cardiac cancer of the remnant stomach was associated with a significantly lower 5-year survival rate compared to primary cardiac cancer (16.7% vs. 28.4%, P = 0.035).
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