DAS LOKAL FORTGESCHRITTENE KARDIAKARZINOM - LOHNT DIE RESEKTION?

Long-term results in 217 patients with carcinoma of the cardia were analyzed prospectively. 43 of the 217 could not be operated upon, either because of their poor general condition (51%), distal metastases (49%), and (or) the primary tumour having advanced too far locally (9%). Two of the 176 patients proved to be inoperable at surgery so that only 174 underwent resection (operation rate 81%; resection rate 99%). The operation risk was no higher for advanced tumour (T₃/T₄) than for earlier tumour stages (T₁/T₂). The tumour was completely resected macroscopically and microscopically (R₀ resection) in 59% of patients in stage T₄. Their median survival time was significantly higher than that for patients with local lymph-node spread (12.5 vs 6.0 months; P < 0.01). Those patients who endoscopically received palliative treatment had a median survival time of 5 months. These results suggest that resection of locally advanced carcinoma of the cardia is worth while, if the tumour can be removed completely both macroscopically and microscopically (R₀ resection).