Should Elderly Patients Undergo Additional Surgery After Non-Curative Endoscopic Resection for Early Gastric Cancer? Long-Term Comparative Outcomes

2011 ◽  
Vol 106 (6) ◽  
pp. 1064-1069 ◽  
Author(s):  
Chika Kusano ◽  
Motoki Iwasaki ◽  
Tonya Kaltenbach ◽  
Abby Conlin ◽  
Ichiro Oda ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Elderly Patients ◽  
Endoscopic Resection ◽  
Additional Surgery

scholarly journals Long-Term Outcomes of Additional Surgery After Noncurative Endoscopic Resection in Patients with Early Gastric Cancer: A Meta-Analysis

2021 ◽  
Author(s):  
Jian Jiao ◽  
Han Li ◽  
Liang Shang ◽  
Hao Wu ◽  
Ronghua Zhang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Endoscopic Resection ◽  
Meta Analysis ◽  
Long Term Results ◽  
Good Survival ◽  
Observation Group ◽  
Surgery Group ◽  
Additional Surgery

Abstract BackgroundThe influence of additional surgery on the prognosis of early gastric cancer who underwent noncurative endoscopic resection was controversial. Different results were observed in different studies. Therefore, this meta-analysis was conducted to evaluate whether additional surgery could produce survival benefits for these patients.MethodsA systematic search was conducted in the PubMed, Embase, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure and Wanfang databases for relevant articles published until 31 March 2021 to investigate the differences in long-term results between the additional surgery group and the observation group. ResultsSixteen studies including 3877 patients were included in this meta-analysis. The results had shown that the surgery group were younger and more male, higher undifferentiated type, higher rate of SM2, lymphatic and vascular invasion, lower recurrence and metastasis than the observation group. Good survival benefits were observed in additional surgery group with obvious significant differences in the 5-year OS, 5-year DSS and 5-year DFS. Similar results were obtained in the subgroup analysis, such as elderly patients (aged ≥70 years) in 5-year OS. ConclusionThis meta-analysis illustrated that significant survival benefits, including 5-year OS, 5-year DSS and 5-year DFS, could be obtained with additional gastrectomy in patients with EGC after noncurative ER, and patients ≥70 years could also benefit from surgery.

scholarly journals The optimal timing of additional surgery after non-curative endoscopic resection to treat early gastric cancer: long-term follow-up study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Jae Hwang Cha ◽  
Jie-Hyun Kim ◽  
Hyoung-Il Kim ◽  
Da Hyun Jung ◽  
Jae Jun Park ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Endoscopic Resection ◽  
Oncological Outcomes ◽  
Additional Surgery ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Group B

AbstractPatients with early gastric cancer (EGC) who undergo non-curative endoscopic resection (ER) require additional surgery. The aim of the study was to validate surgical and oncological outcomes according to the timing of additional surgery after non-curative endoscopic resection. We retrospectively analyzed long-term follow-up data on the 302 patients enrolled between January 2007 and December 2014. We validated our earlier suggestion that the optimal time interval from non-curative ER to additional surgery was 29 days. All patients were divided into two groups by reference to time intervals from ER to additional surgery of ≤29days (n = 133; group A) and >29 days (n = 169; group B). The median follow-up duration was 41.98 ± 21.23 months. As in our previous study, group B exhibited better surgical outcomes. A total of 10 patients developed locoregional or distant recurrences during the follow-up period, but no significant difference was evident between the two groups. Interestingly, the survival rate was better in group B. Group B (>29 days) exhibited better surgical and oncological outcomes. Thus, additional gastrectomy after non-curative ER should be delayed for 1 month to ensure optimal surgical and oncological outcomes.

scholarly journals Comparison between endoscopic treatment and surgery for elderly population with early gastric cancer

2020 ◽  
Author(s):  
Yafen Tang ◽  
Liang Luo ◽  
Xingkang He ◽  
Haotian Chen
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Elderly Patients ◽  
Endoscopic Resection ◽  
Endoscopic Treatment ◽  
Survival Outcomes ◽  
Seer Database ◽  
Term Survival ◽  
Short And Long Term

Abstract Objective Despite of the declining incidence of gastric cancer, the number of elder patients with gastric cancer is increasing because of aging society. The appropriate treatment strategies for elderly patients have not yet been well defined. The aim of this study is sought to evaluate short- and long-term outcomes after different therapies for early gastric cancers in elderly populations. Methods We identified elderly patients aged ≥ 60 years with early gastric cancer (T1 stage) from the Surveillance, Epidemiology and End Results (SEER) database during1998 to 2010. We compared clinic features between different treatment groups and evaluated 1-year, 3-year and 5-year cancer-specific survival outcomes. Results Totally 5639 elderly patients with early gastric cancer were identified from the SEER database (1998–2010). Among them, 2997 patients underwent surgical resection and 328 patients received endoscopic treatment (ET). In a Cox regression model, either surgery or endoscopic resection were associated with improved survival. The short- and long term survival for patients who underwent surgical or endoscopic resection were similar (one-year survival rate (SR) for surgery vs. ET, 89.3% vs. 89.9%, P > 0.05; five-year SR, 77.1% vs. 78.3%, P > 0.05). Conclusions In elderly patients with early gastric cancer, short- and long term survival outcomes were similar between ET and the surgical groups, which indicated that endoscopic therapy is an appropriate and alternative approach for early gastric cancers in older western populations.

Age Affects Clinical Management after Noncurative Endoscopic Submucosal Dissection for Early Gastric Cancer

2019 ◽  
Vol 37 (6) ◽  
pp. 423-433 ◽  
Author(s):  
Mitsuru Esaki ◽  
Waku Hatta ◽  
Tooru Shimosegawa ◽  
Tsuneo Oyama ◽  
Noboru Kawata ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Elderly Patients ◽  
Endoscopic Submucosal Dissection ◽  
Clinical Management ◽  
Elderly Group ◽  
Long Term Outcomes ◽  
Additional Surgery ◽  
The Difference

Background: Additional surgery is recommended after noncurative endoscopic submucosal dissection (ESD) for early gastric cancer due to the risk of lymph node metastasis. However, age may affect the clinical management of these patients. Objectives: The aim of our retrospective multicenter study was to clarify whether age affects decision-making after noncurative ESD and if the decision affects long-term outcomes. Methods: Age was classified as follows: non-elderly, <70 years (n = 811); elderly, 70–79 years (n= 760); and super-elderly, ≥80 years (n = 398). Age associations with the selection for additional surgery were evaluated using logistic regression analysis. Long-term outcomes were also evaluated in each age group. Results: Age was inversely related to the rate of additional surgery, which ranged from 70.0% in the non-elderly group to 20.1% in the super-elderly group (p < 0.001). On multivariate analysis, age <70 years (versus age ≥80 years) was associated with the ­selection of additional surgery (OR 18.6). Overall survival (OS) in patients who underwent additional surgery was ­significantly higher in the non-elderly and elderly groups (p< 0.001), whereas the difference was not significant in the super-elderly group (p = 0.23). Conclusions: Despite the fact that almost 80% of super-elderly patients did not undergo additional surgery, the difference of OS between patients with and without additional surgery was not significant only in patients ≥80 years. Therefore, establishment of criteria for selecting treatment methods after noncurative ESD in elderly patients is required.

Long-term outcomes after endoscopic resection for late elderly patients with early gastric cancer

2021 ◽  
Author(s):  
Kotaro Waki ◽  
Satoki Shichijo ◽  
Noriya Uedo ◽  
Yoshinori Takeuchi ◽  
Akira Maekawa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Elderly Patients ◽  
Endoscopic Resection ◽  
Long Term Outcomes

scholarly journals Impact of Comorbidities, Sarcopenia, and Nutritional Status on the Long-Term Outcomes after Endoscopic Submucosal Dissection for Early Gastric Cancer in Elderly Patients Aged ≥ 80 Years

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3598
Author(s):  
Ga Hee Kim ◽  
Kee Don Choi ◽  
Yousun Ko ◽  
Taeyong Park ◽  
Kyung Won Kim ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Early Gastric Cancer ◽  
Nutritional Status ◽  
Elderly Patients ◽  
Endoscopic Submucosal Dissection ◽  
Term Survival ◽  
Factors Associated ◽  
Submucosal Dissection

Background/Aim: We investigated the oncologic outcomes in elderly patients who underwent endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) by focusing on the impact of comorbidities, sarcopenia, and nutritional status. Methods: Between 2005 and 2016, 280 patients aged ≥ 80 years with 289 EGCs underwent ESD at a tertiary care center. The short- and long-term survival outcomes were assessed. Cox regression analysis was used to identify factors associated with survival, including clinicopathologic factors and abdominal muscle area measured by computed tomography. Results: The rates of en bloc, R0, and, curative resection were 99.3%, 90.0%, and 69.2%, respectively. The rates of post-ESD bleeding and perforation rates were 2.1% and 3.1%, respectively, and no cases showed significant life-threatening adverse events. Over a median follow-up period of 70.5 months, the 3- and 5-year overall survival (OS) rates were 89.5% and 77.1%, respectively; of the114 patients who died, only four (3.5%) were due to gastric cancer. A total of 173 (61.8%) had sarcopenia, and they had lower rates of 3-year (88.4% vs. 91.4%) and 5-year (73.1% vs. 84.0%; p = 0.046) OS than did those without sarcopenia. In multivariable analyses, prognostic nutritional index (hazard ratio [HR], 0.93; 95% confidence interval [CI]: 0.90–0.98; p = 0.002) and Charlson comorbidity index (HR 1.19; 95% CI: 1.03–1.37; p = 0.018) were significant factors associated with overall survival. Conclusions: ESD was a feasible and safe therapeutic method to use in elderly patients, whose long-term survival was significantly associated with nutritional status and comorbidities. These results suggest the need for a possible extension of the curative criteria for ESD in elderly patients with EGC.

Long-term clinical outcomes of endoscopic resection for early gastric cancer

2014 ◽  
Vol 29 (5) ◽  
pp. 1223-1230 ◽  
Author(s):  
Jeongmin Choi ◽  
Sang Gyun Kim ◽  
Jong Pil Im ◽  
Joo Sung Kim ◽  
Hyun Chae Jung
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Clinical Outcomes ◽  
Endoscopic Resection

Long-term outcomes after noncurative endoscopic resection of early gastric cancer: the optimal time for additional endoscopic treatment

2018 ◽  
Vol 87 (4) ◽  
pp. 1003-1013.e2 ◽  
Author(s):  
Mi Young Jeon ◽  
Jun Chul Park ◽  
Kyu Yeon Hahn ◽  
Sung Kwan Shin ◽  
Sang Kil Lee ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Endoscopic Resection ◽  
Endoscopic Treatment ◽  
Optimal Time ◽  
Long Term Outcomes

Additive treatment improves survival in elderly patients after non-curative endoscopic resection for early gastric cancer

2016 ◽  
Vol 31 (3) ◽  
pp. 1376-1382 ◽  
Author(s):  
Da Hyun Jung ◽  
Yong Chan Lee ◽  
Jie-Hyun Kim ◽  
Sang Kil Lee ◽  
Sung Kwan Shin ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Elderly Patients ◽  
Endoscopic Resection ◽  
Additive Treatment
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