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- Title
Prognostic factors for patients 85 years or older undergoing endoscopic submucosal dissection for early gastric cancer.
- Authors
Izumi, Atsuko; Horiuchi, Yusuke; Takamatsu, Manabu; Fukuyama, Chika; Yamamoto, Hiroyuki; Namikawa, Ken; Tokai, Yoshitaka; Yoshimizu, Shoichi; Ishiyama, Akiyoshi; Yoshio, Toshiyuki; Hirasawa, Toshiaki; Fujisaki, Junko; Gotoda, Takuji
- Abstract
Background: Little is known about prognostic factors for patients 85 years or older undergoing endoscopic submucosal dissection for early gastric cancer. Therefore, this study aimed to identify such prognostic factors. Methods: We retrospectively evaluated the long-term outcomes and prognostic factors of 143 patients 85 years or older undergoing endoscopic submucosal dissection for early gastric cancer at a single-center between October 2005 and September 2020. Using the Kaplan–Meier method and a Cox proportional hazards regression model, we examined the relationships of patient characteristics and endoscopic curability (additional gastrectomy recommended [eCuraC-2] or not recommended) with overall survival. Results: The median age of the patients was 86 years, and most patients were men (65%). The eCuraC-2 rate was 14.7%. During the follow-up period, 55 patients died; however, only two patients died due to gastric cancer. The 3-year and 5-year overall survival rates were 91.5% and 74.7%, respectively. Male sex (hazard ratio, 2.23; 95% confidence interval, 1.16–4.30), American Society of Anesthesiologists Physical Status of 3 (hazard ratio, 2.57; 95% confidence interval, 1.32–4.99), body mass index < 18.9 kg/m2 (hazard ratio, 2.21; 95% confidence interval, 1.11–4.40), and eCuraC-2 (hazard ratio, 3.04; 95% confidence interval, 1.37–6.75) were identified as independent prognostic factors. Moreover, patients with eCuraC-2 had significantly more poor prognostic factors than those who did not. Conclusions: The decision to perform endoscopic submucosal dissection for patients with the aforementioned prognostic factors should be carefully considered because follow-up without endoscopic submucosal dissection is possible.
- Subjects
STOMACH tumors; RECEIVER operating characteristic curves; RETROSPECTIVE studies; DESCRIPTIVE statistics; MULTIVARIATE analysis; KAPLAN-Meier estimator; LOG-rank test; GASTROSCOPY; STATISTICS; EARLY diagnosis; CONFIDENCE intervals; DATA analysis software; PROPORTIONAL hazards models; OVERALL survival; SENSITIVITY &; specificity (Statistics); OLD age
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2024, Vol 38, Issue 8, p4306
- ISSN
1866-6817
- Publication type
Article
- DOI
10.1007/s00464-024-10935-3