TRANSTHORACIC RESECTION FOR CANCER OF THE CARDIAC END OF THE STOMACH

Cancer involving the cardiac end of the stomach may be primary in that location, or it may be secondary by extension from either the cardia of the esophagus above or the body of the stomach below. From a pathologic standpoint there is no fundamental difference between such a tumor and those arising in other portions of the stomach or esophagus. A tumor arising in the cardiac portion of the stomach most frequently begins along the lesser curvature, but it may begin in the fundus either anterior or posterior to the gastrophrenic attachment. The former type is readily detected by roentenography and gastroscopy, but the latter may be easily overlooked. The tumor may grow until it is of considerable size before reaching the esophagus, but often it begins to encroach on its outlet relatively early and eventually may infiltrate as much as 2 or 3 cm. of its lower end. If