One of the very important reasons for such a high mortality rate of cardia cancer is the recurrence or metastasis after surgery. It is generally believed that the disease is late and most of them adopt conservative palliative treatment, in fact, the factors causing recurrence and reoccurrence of esophageal cancer and cardia cancer after surgery are more complicated, so let’s learn today why cardia cancer is easy to recur.
The residual cancer at the cutting edge is not only related to the location and length of the lesion, but also related to the subjective factors of the surgeon and the operation method chosen. In cases of pancreatic cancer involving the esophagus, the surgical operation into the abdomen is often insufficient to free and remove the esophagus due to the limitation of the incision, resulting in residual cancer in the upper incisional margin. If the cardia cancer extends to the lesser curvature of the stomach or more than one-half of the stomach body, total gastrectomy should be performed, but some operators reluctantly perform partial gastrectomy resulting in residual lower incisional margin. For mid-thoracic cancer with higher lesion site, esophagogastric anastomosis on the aortic arch is performed, or although neck anastomosis is performed, the resection of esophagus is not enough and the anastomosis is still in the chest after surgery. For middle esophageal cancer, it is generally not advocated to adopt non-opening inside-out extraction, which causes postoperative recurrence due to incomplete resection of tumor remaining in the esophageal bed.
The symptoms of recurrence of cardia cancer may be related to the residue caused by insufficient resection margin or insufficient resection scope in the first operation. Some experts have reported 204 cases of early esophageal cancer and cardia cancer after resection treatment from 10 to 26 years of follow-up results showed that none of the 40 cases of esophagogastric neck anastomosis had recurrence, and 26 cases of recurrence accounted for nearly one-third (29.5%) of the total deaths, all of which were performed by partial esophagectomy and esophagogastric intrathoracic anastomosis, among which 4 cases of postoperative specimens proved that cancer remained in the esophageal cutting edge died within 5 years. Analysis of 719 esophageal cancer resection specimens revealed positive cancer tissue at one end or both ends in 103 cases, accounting for 14.3%, and these cutting edge cancers are the basis of tumor recurrence.
Cardia cancer recurrence symptoms have multiple primary cancer foci in residual esophagus, paracancerous lesions, or residual esophagus and cutting edge, and recurrent cancer after thoracogastric surgery. Even if the residual esophageal cutting edge is clean, it cannot be excluded that there are still cancer foci in other parts, because esophageal epithelial hyperplasia, interstitial lesions and intraepithelial carcinoma can be continuously or intermittently distributed throughout the esophageal mucosa, fully indicating that the esophagus that has suffered from esophageal cancer is highly susceptible to recurrence of cancer.
Therefore, during the treatment process, we should prevent some of the above recurrence factors of pancreatic cancer, take good care of our body and keep a good state of mind.