Endoscopic submucosal dissection vs surgery in elderly patients with early gastric cancer of relative indication for endoscopic resection

2021 ◽  
Author(s):  
Yoshihiro Kishida ◽  
Kohei Takizawa ◽  
Naomi Kakushima ◽  
Noboru Kawata ◽  
Masao Yoshida ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Elderly Patients ◽  
Endoscopic Submucosal Dissection ◽  
Endoscopic Resection ◽  
Submucosal Dissection ◽  
Relative Indication ◽  
Surgery In Elderly

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.

scholarly journals Treatment of Elderly Patients with Early Gastric Cancer by Endoscopic Submucosal Dissection Using an Insulated-tip Diathermic Knife

2005 ◽  
Vol 44 (10) ◽  
pp. 1033-1038 ◽  
Author(s):  
Shoji HIRASAKI ◽  
Masahito TANIMIZU ◽  
Junichirou NASU ◽  
Toshiyuki SHINJI ◽  
Norio KOIDE
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Elderly Patients ◽  
Endoscopic Submucosal Dissection ◽  
Submucosal Dissection

Tu1698 Indications of Endoscopic Submucosal Dissection for Early Gastric Cancer in Elderly Patients

2012 ◽  
Vol 75 (4) ◽  
pp. AB492-AB493
Author(s):  
Satoshi Tokioka ◽  
Eiji Umegaki ◽  
Nozomi Takeuchi ◽  
Toshihisa Takeuchi ◽  
Yukiko Yoda ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Elderly Patients ◽  
Endoscopic Submucosal Dissection ◽  
Submucosal Dissection
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