The Safety and Clinical Validity of Endoscopic Submucosal Dissection for Early Gastric Cancer in Patients Aged More Than 85 Years

Endoscopic submucosal dissection (ESD) is a safe and minimally invasive method for the treatment of early gastric cancer (EGC). However, whether ESD for EGC is also safe and feasible in patients aged ≥85 years is unclear. The patients enrolled in this study were divided into three groups: age ≥85 ye...

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Published in:Cancers 2022-07, Vol.14 (14), p.3311
Main Authors: Yoshikawa, Takaaki, Yamauchi, Atsushi, Hamasaki, Ryuhei, Mori, Yuki, Osawa, Kazuki, Ito, Ryo, Kawai, Yuya, Nakagami, Souta, Azuma, Shunjiro, Morita, Toshihiro, Hirohashi, Kenshiro, Kuriyama, Katsutoshi, Takahashi, Ken, Kou, Tadayuki, Kondoh, Hiroshi, Yazumi, Shujiro
Format: Article
Language:English
Subjects:
Adverse events
Age
Cancer therapies
Dissection
Endoscopy
Gastric cancer
Gastrointestinal surgery
Lesions
Life expectancy
Medical prognosis
Medical records
Mortality
Nutritional status
Patients
Pneumonia
Prognosis
Quality of life
Survival
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Summary:Endoscopic submucosal dissection (ESD) is a safe and minimally invasive method for the treatment of early gastric cancer (EGC). However, whether ESD for EGC is also safe and feasible in patients aged ≥85 years is unclear. The patients enrolled in this study were divided into three groups: age ≥85 years (44 patients, 49 lesions), age 65−84 years (624 patients, 687 lesions), and age ≤64 years (162 patients, 174 lesions). We evaluated the incidence of adverse events (AEs) and overall survival (OS) and disease-specific survival (DSS). We analyzed the factors that had a significant impact on the prognosis of patients aged ≥85 years. No significant differences were found in the incidence of AEs among the three groups (p = 0.612). The OS was significantly lower in patients aged ≥85 years (p < 0.001). Conversely, DSS was not significantly worse in patients aged ≥85 years (p = 0.100). The poor Geriatric Nutritional Risk Index correlated with poor prognosis in patients aged ≥85 years (p < 0.001). ESD is a safe and valid treatment for EGC in patients aged ≥85 years. However, the indications should be carefully decided because it is difficult to estimate the survival contribution of ESD for EGC in patients aged ≥85 years, especially in those with poor nutritional status.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers14143311