Natural history of early esophageal squamous carcinoma and early adenocarcinoma of the gastric cardia in the People's Republic of China.

Ninety cases of early esophageal squamous carcinoma (EESC) and 27 patients with early adenocarcinoma of the gastric cardia (EAGC), who for various reasons refused surgical treatment, radiotherapy or chemotherapy, were followed up endoscopically and roentgenologically for 19 to 78 months. Of the 90 cases with EESC, 52 (58%) were still found to have superficial mucosal lesions, 8 cases progressed to an advanced stage, 27 died of cancer with an average survival time of 53.2 months, and 3 died of other non-malignant diseases. The estimated median survival time of EESC is about 75 months. Among 21 patients with EAGC, 8 (30%) were still presenting with superficial malignant changes, 6 cases progressed to advanced cancer, 11 died of carcinoma with an average survival time of 53.3 months, and 2 died of non-malignant diseases. The estimated median survival time of EAGC is about 73 months. The period for a carcinoma in situ of the esophagus and the gastric cardia to progress to an advanced stage appears to be 4-5 years.