BACKGROUND AND AIMS: Epidemiological studies show a continuing rise in the prevalence of upper-third gastric carcinoma. We compared the clinicopathologic features and prognosis in these patients, with and without lower esophageal invasion. PATIENTS AND METHODS: We reviewed the hospital records of 42 patients with lower esophageal invasion seen between 1986 and 2000. RESULTS: Borrmann type IV gastric carcinoma was more frequently found in patients with esophageal invasion (P < 0.001). Multivariate analysis indicated that curability, the extent of lymph node dissection, and lymph node metastases were significant prognostic factors. When the patients with esophageal invasion were divided into those with or without curative resection, the 5-year survival rates were 37.3% and 0%, respectively (P < 0.001). In patients with lymph node dissection above the D2 lymph node, the 5-year survival rate was higher than that of patients with dissection below the D2 node level (34.4% vs 0%, P < 0.001). CONCLUSION: According to our results, curative resection and extensive lymph node dissection were the determining factors in improving survival.
BACKGROUND AND AIMS: Epidemiological studies show a continuing rise in the prevalence of upper-third gastric carcinoma. We compared the clinicopathologic features and prognosis in these patients, with and without lower esophageal invasion. PATIENTS AND METHODS: We reviewed the hospital records of 42 patients with lower esophageal invasion seen between 1986 and 2000. RESULTS: Borrmann type IV gastric carcinoma was more frequently found in patients with esophageal invasion (P < 0.001). Multivariate analysis indicated that curability, the extent of lymph node dissection, and lymph node metastases were significant prognostic factors. When the patients with esophageal invasion were divided into those with or without curative resection, the 5-year survival rates were 37.3% and 0%, respectively (P < 0.001). In patients with lymph node dissection above the D2 lymph node, the 5-year survival rate was higher than that of patients with dissection below the D2 node level (34.4% vs 0%, P < 0.001). CONCLUSION: According to our results, curative resection and extensive lymph node dissection were the determining factors in improving survival.