Cancer of the distal esophagus and cardia. Incidence, tumorous infiltration, and metastatic spread.

The report concerns the findings of autopsies performed at the Institute of Pathology, The University of Düsseldorf, where 68 patients with cancer of the distal esophagus and 117 patients with cancer of the cardia were observed between 1950 and 1982. The total number of autopsies during this 33-year observation period was 46,593. The male:female ratio was 5.8:1 in cancer of the distal esophagus, and 4.3:1 in cancer of the cardia. During the observation period, cancer of the distal esophagus accounted, on average, for about 40% of all esophageal cancers, whereas the percentage of cancers of the cardia among all gastric cancers was 15.4% on average. While the incidence of gastric cancer has decreased overall, a relative increase in cancers of the cardia has been found, especially in the last 8 years. In histological terms, most of the malignomas of the distal esophagus were squamous cell carcinomas (84%), and most of the cancers of the cardia were adenocarcinomas (96%). Tumor spread and lymphogenous and hematogenous metastasizing are discussed, and the findings are compared with the literature.