The Safety and Clinical Validity of Endoscopic Submucosal Dissection for Early Gastric Cancer in Patients Aged More Than 85 Years
Endoscopic submucosal dissection (ESD) is a safe and minimally invasive method for the treatment of early gastric cancer (EGC). However, whether ESD for EGC is also safe and feasible in patients aged ≥85 years is unclear. The patients enrolled in this study were divided into three groups: age ≥85 ye...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-07-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/14/3311 |
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| author | Takaaki Yoshikawa Atsushi Yamauchi Ryuhei Hamasaki Yuki Mori Kazuki Osawa Ryo Ito Yuya Kawai Souta Nakagami Shunjiro Azuma Toshihiro Morita Kenshiro Hirohashi Katsutoshi Kuriyama Ken Takahashi Tadayuki Kou Hiroshi Kondoh Shujiro Yazumi |
| author_facet | Takaaki Yoshikawa Atsushi Yamauchi Ryuhei Hamasaki Yuki Mori Kazuki Osawa Ryo Ito Yuya Kawai Souta Nakagami Shunjiro Azuma Toshihiro Morita Kenshiro Hirohashi Katsutoshi Kuriyama Ken Takahashi Tadayuki Kou Hiroshi Kondoh Shujiro Yazumi |
| author_sort | Takaaki Yoshikawa |
| collection | DOAJ |
| description | Endoscopic submucosal dissection (ESD) is a safe and minimally invasive method for the treatment of early gastric cancer (EGC). However, whether ESD for EGC is also safe and feasible in patients aged ≥85 years is unclear. The patients enrolled in this study were divided into three groups: age ≥85 years (44 patients, 49 lesions), age 65–84 years (624 patients, 687 lesions), and age ≤64 years (162 patients, 174 lesions). We evaluated the incidence of adverse events (AEs) and overall survival (OS) and disease-specific survival (DSS). We analyzed the factors that had a significant impact on the prognosis of patients aged ≥85 years. No significant differences were found in the incidence of AEs among the three groups (<i>p</i> = 0.612). The OS was significantly lower in patients aged ≥85 years (<i>p</i> < 0.001). Conversely, DSS was not significantly worse in patients aged ≥85 years (<i>p</i> = 0.100). The poor Geriatric Nutritional Risk Index correlated with poor prognosis in patients aged ≥85 years (<i>p</i> < 0.001). ESD is a safe and valid treatment for EGC in patients aged ≥85 years. However, the indications should be carefully decided because it is difficult to estimate the survival contribution of ESD for EGC in patients aged ≥85 years, especially in those with poor nutritional status. |
| first_indexed | 2024-03-09T10:21:04Z |
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| id | doaj.art-3db97af45557471ba1024dc33ef2e603 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T10:21:04Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-3db97af45557471ba1024dc33ef2e6032023-12-01T21:59:04ZengMDPI AGCancers2072-66942022-07-011414331110.3390/cancers14143311The Safety and Clinical Validity of Endoscopic Submucosal Dissection for Early Gastric Cancer in Patients Aged More Than 85 YearsTakaaki Yoshikawa0Atsushi Yamauchi1Ryuhei Hamasaki2Yuki Mori3Kazuki Osawa4Ryo Ito5Yuya Kawai6Souta Nakagami7Shunjiro Azuma8Toshihiro Morita9Kenshiro Hirohashi10Katsutoshi Kuriyama11Ken Takahashi12Tadayuki Kou13Hiroshi Kondoh14Shujiro Yazumi15Department of Gastroenterology and Hepatology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, 2-4-20, Ohgimachi, Kita-ku, Osaka 530-8480, JapanDepartment of Gastroenterology and Hepatology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, 2-4-20, Ohgimachi, Kita-ku, Osaka 530-8480, JapanDepartment of Gastroenterology and Hepatology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, 2-4-20, Ohgimachi, Kita-ku, Osaka 530-8480, JapanDepartment of Gastroenterology and Hepatology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, 2-4-20, Ohgimachi, Kita-ku, Osaka 530-8480, JapanDepartment of Gastroenterology and Hepatology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, 2-4-20, Ohgimachi, Kita-ku, Osaka 530-8480, JapanDepartment of Gastroenterology and Hepatology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, 2-4-20, Ohgimachi, Kita-ku, Osaka 530-8480, JapanDepartment of Gastroenterology and Hepatology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, 2-4-20, Ohgimachi, Kita-ku, Osaka 530-8480, JapanDepartment of Gastroenterology and Hepatology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, 2-4-20, Ohgimachi, Kita-ku, Osaka 530-8480, JapanDepartment of Gastroenterology and Hepatology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, 2-4-20, Ohgimachi, Kita-ku, Osaka 530-8480, JapanDepartment of Gastroenterology and Hepatology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, 2-4-20, Ohgimachi, Kita-ku, Osaka 530-8480, JapanDepartment of Gastroenterology and Hepatology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, 2-4-20, Ohgimachi, Kita-ku, Osaka 530-8480, JapanDepartment of Gastroenterology and Hepatology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, 2-4-20, Ohgimachi, Kita-ku, Osaka 530-8480, JapanDepartment of Gastroenterology and Hepatology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, 2-4-20, Ohgimachi, Kita-ku, Osaka 530-8480, JapanDepartment of Gastroenterology and Hepatology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, 2-4-20, Ohgimachi, Kita-ku, Osaka 530-8480, JapanDepartment of Geriatric Unit, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, JapanDepartment of Gastroenterology and Hepatology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, 2-4-20, Ohgimachi, Kita-ku, Osaka 530-8480, JapanEndoscopic submucosal dissection (ESD) is a safe and minimally invasive method for the treatment of early gastric cancer (EGC). However, whether ESD for EGC is also safe and feasible in patients aged ≥85 years is unclear. The patients enrolled in this study were divided into three groups: age ≥85 years (44 patients, 49 lesions), age 65–84 years (624 patients, 687 lesions), and age ≤64 years (162 patients, 174 lesions). We evaluated the incidence of adverse events (AEs) and overall survival (OS) and disease-specific survival (DSS). We analyzed the factors that had a significant impact on the prognosis of patients aged ≥85 years. No significant differences were found in the incidence of AEs among the three groups (<i>p</i> = 0.612). The OS was significantly lower in patients aged ≥85 years (<i>p</i> < 0.001). Conversely, DSS was not significantly worse in patients aged ≥85 years (<i>p</i> = 0.100). The poor Geriatric Nutritional Risk Index correlated with poor prognosis in patients aged ≥85 years (<i>p</i> < 0.001). ESD is a safe and valid treatment for EGC in patients aged ≥85 years. However, the indications should be carefully decided because it is difficult to estimate the survival contribution of ESD for EGC in patients aged ≥85 years, especially in those with poor nutritional status.https://www.mdpi.com/2072-6694/14/14/3311early gastric cancerendoscopic submucosal dissectionelderly patientsoverall survivalprognosis |
| spellingShingle | Takaaki Yoshikawa Atsushi Yamauchi Ryuhei Hamasaki Yuki Mori Kazuki Osawa Ryo Ito Yuya Kawai Souta Nakagami Shunjiro Azuma Toshihiro Morita Kenshiro Hirohashi Katsutoshi Kuriyama Ken Takahashi Tadayuki Kou Hiroshi Kondoh Shujiro Yazumi The Safety and Clinical Validity of Endoscopic Submucosal Dissection for Early Gastric Cancer in Patients Aged More Than 85 Years Cancers early gastric cancer endoscopic submucosal dissection elderly patients overall survival prognosis |
| title | The Safety and Clinical Validity of Endoscopic Submucosal Dissection for Early Gastric Cancer in Patients Aged More Than 85 Years |
| title_full | The Safety and Clinical Validity of Endoscopic Submucosal Dissection for Early Gastric Cancer in Patients Aged More Than 85 Years |
| title_fullStr | The Safety and Clinical Validity of Endoscopic Submucosal Dissection for Early Gastric Cancer in Patients Aged More Than 85 Years |
| title_full_unstemmed | The Safety and Clinical Validity of Endoscopic Submucosal Dissection for Early Gastric Cancer in Patients Aged More Than 85 Years |
| title_short | The Safety and Clinical Validity of Endoscopic Submucosal Dissection for Early Gastric Cancer in Patients Aged More Than 85 Years |
| title_sort | safety and clinical validity of endoscopic submucosal dissection for early gastric cancer in patients aged more than 85 years |
| topic | early gastric cancer endoscopic submucosal dissection elderly patients overall survival prognosis |
| url | https://www.mdpi.com/2072-6694/14/14/3311 |
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