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Short- and Long-term Outcomes of Endoscopic Submucosal Dissection for T1 Early Gastric Cancer Beyond the Indication in Elderly Patients(≥80 Years) Yoshihiro Kishida 1 , Kohei Takizawa 1 , Yoichi Yamamoto 1 , Yohei Yabuuchi 1 , Masao Yoshida 1 , Noboru Kawata 1 , Etsuro Bando 2 , Masanori Terashima 2 , Hiroyuki Ono 1 1Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan 2Division of Gastric Surgery, Shizuoka Cancer Center, Shizuoka, Japan Keyword: 早期胃癌 , 相対適応 , ESD , 外科手術 , 高齢者 pp.1475-1486
Published Date 2020/11/25
DOI https://doi.org/10.11477/mf.1403202184
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 Surgery is the standard of care for cT1 EGC(early gastric cancer)beyond the indications for ER(endoscopic resection), but providers may opt for ER for reasons such as age and comorbidities. However, there are few reports on the outcomes of these treatments, and there is no consensus on treatment selection and effectiveness. In this study, we evaluated the outcomes of ESD(endoscopic submucosal dissection)and surgery for cT1 EGC beyond ER indication in elderly patients(≥80 years). Twelve percent of the lesions were pathologically eCureA, B, and C-1. In patients who were followed up without surgery after eCureC-2 resection of ESD, the rate of deaths from gastric cancer was about 23.5% of all deaths.

 On the other hand, deaths from gastric cancer were also found in 20.5% of all deaths in patients who underwent surgery for initial treatment. In a case comparison of ESD alone and surgery, the survival curves of the two groups did not differ significantly, and gender and prognostic nutritional index were extracted as preoperative prognostic factors contributing to survival. In elderly patients, factors other than curability may affect long-term survival ; thus, these factors should be considered in determining the treatment plan.


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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