In:
Digestive Endoscopy, Wiley, Vol. 30, No. 5 ( 2018-09), p. 616-623
Abstract:
With the aging of society, comorbidities or nutritional status are assessed prior to endoscopic submucosal dissection ( ESD ) for early gastric cancer ( EGC ). However, it is uncertain which factors are important for predicting prognosis in EGC patients after ESD . Thus, we aimed to evaluate clinical outcomes of ESD for EGC , with respect to comorbidities or nutritional status. Methods We carried out a retrospective study involving 708 EGC in 585 patients who were enrolled between April 2007 and March 2012. They were classified into two groups; an elderly (≥80 years) and non‐elderly ( 〈 80 years) group. Short‐ and long‐term outcomes were evaluated between the groups. Results There were no significant differences regarding short‐term outcomes. Overall survival ( OS ) rates in the elderly group were significantly lower than those in the non‐elderly group ( P = 0.001). OS rates in patients with a low (≤2) Charlson comorbidity index ( CCI ) were significantly higher than those in patients with a high (≥3) CCI , regardless of age. OS rates in patients with a high (≥47.7) prognostic nutritional index ( PNI ) were significantly higher than those in patients with a low ( 〈 47.7) PNI , regardless of age. In multivariate analysis, an Eastern Cooperative Oncology Group performance status ( PS ) ≥2 (hazard ratio [ HR ], 95% confidence interval: 3.23, 1.54–6.75), CCI ≥3 ( HR 7.88, 4.50–13.80) and PNI 〈 47.7 ( HR 3.44, 2.00–5.90) were significantly associated with OS rate ( P 〈 0.01). Conclusion CCI and PNI can be prognostic indicators for non‐elderly and elderly patients with EGC after ESD .
Type of Medium:
Online Resource
ISSN:
0915-5635
,
1443-1661
DOI:
10.1111/den.2018.30.issue-5
Language:
English
Publisher:
Wiley
Publication Date:
2018
detail.hit.zdb_id:
2020071-7
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