[Therapy and prognosis of cardia carcinoma. Study on 225 cases]

From 1955 to 1974, 225 patients with cardia carcinoma were treated at the Department of Surgery in the University of Göttingen. The resection rate was 46,6%. Only 35 of our 105 patients who underwent resection, were operated on radically; in all other patients a palliative resection was done. In 59% of the resection cases a abdominothoracic approach was performed, whereas in 21% an abdominal, and in 20% a thoracic approach was preferred. The abdominal approach seems to be less effective, since a radical operation in most cases was not guaranteed. In 62% of the resected cases, postoperative complications occurred, mainly of pulmonal origin. The postoperative lethality was 18.1%. The prognosis depends on the degree of tumor metastases. The mean survival rate of the radically operated patients was 36.2 months, compared to 9.7 months of the palliatively resected cases. The 5-year survival rate of the resected patients was 12.2%. An improvement of the results can only be achieved by increasing the resection rate and earlier detection of the tumors.