In:
Endoscopy International Open, Georg Thieme Verlag KG, Vol. 05, No. 01 ( 2017-01), p. E17-E24
Abstract:
Background and study aims The safety and efficacy of endoscopic submucosal
dissection (ESD) for early gastric cancer (EGC) in very elderly patients remains unclear. The aim of this study was to evaluate the safety and efficacy of ESD
for EGC in patients age 85 years and older. Patients and methods Patients who underwent ESD for EGC between September
2003 and April 2015 were divided into 3 groups: the very elderly (≥ 85 years; 43 patients), the elderly (65 – 84 years; 511 patients), and the non-elderly ( ≤ 64
years; 161 patients). Adverse events (AEs) were used as the primary endpoint to assess the safety of ESD, and the ESD treatment outcomes (i. e., en bloc
resection rate, complete en bloc resection rate, and curative resection rate) and the overall survival rate after ESD were the secondary endpoints.
These parameters were retrospectively evaluated in the 3 groups. Results There were no significant differences in AEs (non-elderly,
elderly, and very elderly: 7.3, 9.5, and 12.5 %, respectively, P = 0.491) or in the en bloc resection and complete en bloc resection rates
among the three groups. However, there was a significant difference in the curative resection rates (non-elderly, elderly, and very elderly: 91.5, 84.1,
and 77.1 %, respectively, P = 0.014). Regarding overall survival, there was a significant difference among the three groups (1-, 5-, and 10-year overall
survival rates: non-elderly: 98.6, 90.2, and 74.7 %; elderly: 97.2, 86.2, and 61.9 %; and very elderly: 92.7, 66.8, and 34.4 %, respectively,
P = 0.001). Moreover, the overall survival rate in the very elderly patients with cardiovascular disease was significantly lower than that in the
very elderly patients without cardiovascular disease (P 〈 0.001). Conclusions ESD is an acceptable treatment for EGC in patients 85 years of
age or older in terms of safety. However, the overall survival after ESD in the very elderly patients with cardiovascular disease was
short.
Type of Medium:
Online Resource
ISSN:
2364-3722
,
2196-9736
DOI:
10.1055/s-0042-122960
Language:
English
Publisher:
Georg Thieme Verlag KG
Publication Date:
2017
detail.hit.zdb_id:
2761052-4
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