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Surgical Endoscopy
Published in: Surgical Endoscopy 10/2016

01-10-2016

Long-term prognosis after endoscopic submucosal dissection for early gastric cancer in super-elderly patients

Authors: Yoshikazu Yoshifuku, Shiro Oka, Shinji Tanaka, Yoji Sanomura, Tomohiro Miwata, Norifumi Numata, Toru Hiyama, Kazuaki Chayama

Published in: Surgical Endoscopy | Issue 10/2016

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Abstract

Background

No previous study has confirmed the safety of endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) in the super-elderly patient population. The current study aimed to evaluate the validity of ESD for EGC in super-elderly patients aged ≥85 years with comorbidities.

Methods

Our study group included 85 super-elderly patients (102 EGCs) who were diagnosed at Hiroshima University Hospital between April 2002 and October 2014. We evaluated the en bloc resection rates, R0 resection rates, complication rates, and prognosis in relation to the degree of comorbidities (group A–H, patients with high-risk comorbidities; group A–L, patients with low-risk comorbidities; group B, patients without comorbidities; and group C, patients followed without ESD).

Results

The en bloc resection rates were 100, 96, and 100 % in groups A–H, A–L, and B, respectively. R0 resection rates were 94, 96, and 94 % in groups A–H, A–L, and B, respectively. There were no severe complications related to ESD. During the follow-up period, there was a significantly higher frequency of death in group A than in group B (p < 0.01), and there were no significant differences between groups A–H and A–L. However, there were no cases of death related to gastric cancer.

Conclusions

ESD was performed safely, and death related to gastric cancer was prevented in super-elderly patients with comorbidities, regardless of the degree of the disease. However, patients with comorbidities are at a high risk of poor prognosis.
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Metadata
Title
Long-term prognosis after endoscopic submucosal dissection for early gastric cancer in super-elderly patients
Authors
Yoshikazu Yoshifuku
Shiro Oka
Shinji Tanaka
Yoji Sanomura
Tomohiro Miwata
Norifumi Numata
Toru Hiyama
Kazuaki Chayama
Publication date
01-10-2016
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 10/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-016-4751-y

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