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Surgical Endoscopy

, Volume 30, Issue 10, pp 4321–4329 | Cite as

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

  • Yoshikazu Yoshifuku
  • Shiro OkaEmail author
  • Shinji Tanaka
  • Yoji Sanomura
  • Tomohiro Miwata
  • Norifumi Numata
  • Toru Hiyama
  • Kazuaki Chayama
Article

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.

Keywords

Early gastric cancer Endoscopic submucosal dissection Super-elderly patients, comorbidities 

Notes

Compliance with ethical standards

Disclosures

Yoshikazu Yoshifuku, Shiro Oka, Shinji Tanaka, Yoji Sanomura, Tomohiro Miwata, Norifumi Numata, Toru Hiyama and Kazuaki Chayama have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Yoshikazu Yoshifuku
    • 1
  • Shiro Oka
    • 2
    Email author
  • Shinji Tanaka
    • 2
  • Yoji Sanomura
    • 1
  • Tomohiro Miwata
    • 1
  • Norifumi Numata
    • 1
  • Toru Hiyama
    • 3
  • Kazuaki Chayama
    • 1
  1. 1.Department of Gastroenterology and Metabolism, Graduate School of Biomedical SciencesHiroshima UniversityHiroshimaJapan
  2. 2.Department of EndoscopyHiroshima University HospitalHiroshimaJapan
  3. 3.Health Service CenterHiroshima UniversityHigashihiroshimaJapan

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