Difference between carcinoma of the lower esophagus and the cardia.

We analyzed the records of patients with carcinoma of the lower esophagus and cardia. Mediastinal node involvement was found in 43% of the patients with squamous cell carcinoma of the lower esophagus, and the 5-year survival after mediastinal dissection for patients with mediastinal node involvement was 27%. Mediastinal node involvement was found in 19% of the patients with adenocarcinoma of the cardia involving the esophagus, and no patients with mediastinal node involvement survived more than 2 years. When the patients had mediastinal node involvement, survival curves were significantly different. There were large differences between these tumors in terms of the extent of lymph node involvement and the survival of patients with mediastinal lymph node involvement. It is incorrect to consider the behavior of these tumors identical and to treat the conditions similarly.