الفهرس | Only 14 pages are availabe for public view |
Abstract Tumor differentiation was a prognostic parameter with an inferior prognosis in undifferentiated tumor with median survival of 19 months for grade I + II and 13. months for grade III + IV with p value 0~008 as shown in table (12). There was a difference in the distribution of the undifferentiated tumors among the three groups (10%, 13.3%and 12.5%) for type I, II and III respectively a~ shown in table (7). This is reported in other studies (Siewert et al., 2000 and Ellis et aI., 1997). Siewert and colleagues postulated that this finding is one of several epidemiological facts that provide justification for their classifications, that is the topographic classification also correctly reflect the pathogenesis of the different types of esophago-gastric junction tumors. Tumor stage, depth, the number and rate of involved nodes were predictors of survival of this, study as in table (11). In another study of 100 cases of type I carcinoma Hagen and colleagues (Hagen et aI., 2001) had similar results. In another study, tumor stage was the only significant. prognostic factor (Launoiset aI., 1994). Siewert and coileagues found that tumor resection and lymph node states were the dominating independent prognostic factors for 1002 consecutive patients with carcinoma of the cardia (Siewert et aI., 2000). In a recent study, survival was significantly associated with stage and the presence of lymph node metastases and not correlated to type and surgical approach (Sole rio et aI., 2003). McCulloch and colleagues found that tumor stage and type of operation were significant predictors. Patients undergoing partial gastrectomy were at significantly less risk than others (McCulloch et al., 2003). |