scholarly journals Long-Term Clinical Outcomes of Endoscopic Submucosal Dissection in Patients with Early Gastric Cancer: A Prospective Multicenter Cohort Study

Gut and Liver ◽  
2018 ◽  
Vol 12 (4) ◽  
pp. 402-410 ◽  
Author(s):  
Sang Gyun Kim ◽  
Chan Mi Park ◽  
Na Rae Lee ◽  
Jiyoung Kim ◽  
Da Hyun Lyu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cohort Study ◽  
Early Gastric Cancer ◽  
Endoscopic Submucosal Dissection ◽  
Clinical Outcomes ◽  
Multicenter Cohort Study ◽  
Submucosal Dissection ◽  
Multicenter Cohort

scholarly journals Long-Term Outcomes and Prognostic Factors of Endoscopic Submucosal Dissection for Early Gastric Cancer in Patients Aged ≥75 Years

Cancers ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3222
Author(s):  
Jin Won Chang ◽  
Da Hyun Jung ◽  
Jun Chul Park ◽  
Sung Kwan Shin ◽  
Sang Kil Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Prognostic Factors ◽  
Early Gastric Cancer ◽  
Elderly Patients ◽  
Endoscopic Submucosal Dissection ◽  
Clinical Outcomes ◽  
Risk Group ◽  
Submucosal Dissection

Background and Aims: The number of elderly patients with early gastric cancer (EGC) who meet the indications for endoscopic submucosal dissection (ESD) is increasing. We aimed to evaluate the clinical outcomes and prognostic factors of overall survival (OS) in elderly patients undergoing ESD for EGC. Methods: Between January 2006 and December 2018, 439 patients aged ≥75 years who underwent ESD for EGC were analyzed. The clinical outcomes and prognosis were evaluated, and independent risk factors for OS were identified. Results: The mean patient (302 men, 137 women) age was 78.3 (range 75–92) years. En bloc, R0, and curative resections were achieved in 96.8%, 90.7%, and 75.6%, respectively, without severe adverse events. During the follow-up (median 54.2 (range 4.0–159.6) months), 86 patients died (three of gastric cancer). The 3-, 5-, and 10-year OS was 91.2%, 83.5%, and 54.5%, respectively, and the 3-, 5-, and 10-year cancer related survival rate were 99.7%, 99.1% and 97.5%, respectively. In multivariate analysis, smoking, history of cancer of other organs, NLR > 1.6, Charlson comorbidity index ≥ 3, and presence of lymphovascular invasion (hazard ratio = 3.96, 1.78, 1.83, 1.83, and 2.63, respectively, all p < 0.05) were independent five risk factors for poor OS. The high-risk group (≥3 risk factors) showed a significantly lower OS than the low-risk group (<2 risk factors) (p < 0.001). Conclusions: The five factors could be useful in predicting the long-term prognosis of elderly ESD patients or deciding the therapeutic approaches in case of non-curative resection.

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