Abstract
Introduction: Adenocarcinoma near the esophagogastric junction is one of the most lethal GI malignancies known. Surgical treatment of these cancers stay determinative factors of patient survival. Older persons often differ from the younger adult population in terms of biological and functional perspectives; as such, they may have particular needs which require an interdisciplinary approach and intervention, especially when faced with a cancer diagnosis. The aim of this study was to detected expression of TGF-ß and CD-44 in age specific subgroup. Methods: The expressions of TGF-ß and CD-44 were evaluated immunohistochemically in 23 patients with adenocarcinoma of gastric cardia who underwent curative surgery (R0) without any neo/adjuvant therapy. Additionally we analyzed control group of patients with non-cancer lesion or normal tissue of upper digestive tract (13 patients). We divided the patients into two groups. Group A consisted of 13 cancer patients and 7 control patients 65 years of age or older, while Group B consisted of 10 cancer and 6 control patients younger than 65 years of age. The two groups were comparable - there were no differences between the two groups regarding tumor stage. Results: Elderly patients have statistically significant better survival (median 20,2 month) compared with younger patients (median 15,4 month) (p = 0.045). The median survival rate of patients without TGF-ß and/or CD-44 expression was significantly lower (7m) than that of patients with positive expression (>15m) (p = 0.003). Regardless of patients age, CD-44 was significantly higher in the cancer tissue of elderly patients than in younger (p < 0,035). But no significant difference was observed in the TGF-ß expression between group A and group B cancers tissue (p = 0.005). Conclusion: The biology of tumors may be different in elderly patients, leading to a lower rate of tumor-related mortality.
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