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Safety and efficacy of colorectal endoscopic submucosal dissection in elders: clinical and follow-up outcomes

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Endoscopic submucosal dissection (ESD) has recently been applied to treatment of colorectal neoplasia; however, its safety and efficacy in terms of follow-up outcomes in elders have not been thoroughly examined. The aim of this study is to describe the clinical outcomes of colorectal ESD in elderly patients.

Methods

Two groups of patients, elderly (≥75 years of age) and non-elderly (<75 years of age), who underwent colorectal ESD at the National Cancer Center Hospital from February 1998 to December 2010 were retrospectively compared on the following measures: tumor size, procedure time, complication rates, en bloc resection rates, and curative resection rates. We also investigated the follow-up outcomes in non-curative resection cases.

Results

Of 614 consecutive patients treated by colorectal ESD, 125 (20.4 %) comprised the elderly group, and 489 patients (79.6 %) comprised the non-elderly group. No significant differences were observed between the two groups in terms of tumor size, procedure time, complication rates, en bloc resection rates, and curative resection rates. Of the patients who underwent non-curative resection, 7/19 (36.8 %) and 47/63 (74.6 %) in the elderly and non-elderly group, respectively, underwent additional treatment. Among the elderly patients who were followed up without additional treatment, no case of local recurrence, residual lesions, or distant metastases was observed during the observation period.

Conclusion

Treatment outcomes of colorectal ESD were equivalent in both groups. However, many of the non-curative cases in the elderly patients were followed up without additional treatment. Future studies should focus on the outcome in such patients to confirm the feasibility of colorectal ESD in elderly patients.

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Conflicts of interest

All authors have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Naoto Tamai, Yutaka Saito, Taku Sakamoto, Takeshi Nakajima & Takahisa Matsuda

  2. Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan

    Naoto Tamai & Hisao Tajiri

  3. Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan

    Hisao Tajiri

Authors
  1. Naoto Tamai
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  2. Yutaka Saito
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  3. Taku Sakamoto
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  4. Takeshi Nakajima
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  5. Takahisa Matsuda
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  6. Hisao Tajiri
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Correspondence to Naoto Tamai.

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Tamai, N., Saito, Y., Sakamoto, T. et al. Safety and efficacy of colorectal endoscopic submucosal dissection in elders: clinical and follow-up outcomes. Int J Colorectal Dis 27, 1493–1499 (2012). https://doi.org/10.1007/s00384-012-1514-7

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  • DOI: https://doi.org/10.1007/s00384-012-1514-7

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