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Surgical Endoscopy

, Volume 31, Issue 10, pp 3905–3911 | Cite as

Efficacy and safety of endoscopic submucosal dissection in elderly patients with esophageal squamous cell carcinoma

  • Byeong Geun Song
  • Yang Won Min
  • Jun Haeng LeeEmail author
  • Hyuk Lee
  • Byung-Hoon Min
  • Poong-Lyul Rhee
  • Jae J. Kim
Article

Abstract

Background

Endoscopic submucosal dissection (ESD) has been widely applied in superficial esophageal squamous cell carcinoma (SESCC) as a minimally invasive treatment, which has advantages over surgery, especially in the elderly who have high risk of surgery. This study elucidated the efficacy and safety of ESD for SESCC in the elderly.

Methods

Between April 2007 and June 2016, a total of 176 patients with SESCC treated with ESD were analyzed. Clinical outcomes including En bloc, complete, and curative resection rates, procedure-related complication rates, and cumulative recurrence rates were compared between the elderly (n = 46, ≥70 years of age) and the non-elderly groups (n = 130, <70 years of age).

Results

Between the two groups, sex, past medical history (hypertension and diabetes), body mass index, tumor characteristics (number, location, shape, maximal and circumferential size of the tumor and the resected specimen, and depth), and use of stricture prevention except for age (elderly vs non-elderly; 74.1 ± 2.78 vs. 61.1 ± 6.06 years, p < 0.001) did not differ. En bloc resection (elderly vs. non-elderly; 93.5 vs. 93.8%, p = 1.000), complete resection (elderly vs. non-elderly; 69.6 vs. 76.2%, p = 0.433), and curative resection rates (elderly vs. non-elderly; 54.3 vs. 60.0%, p = 0.602) did not differ significantly between the two groups. Procedure time and hospital stay were also similar between the two groups. Complications of ESD such as stricture (17.4 vs. 10.8%, p = 0.299) and perforation (13.0 vs. 6.2%, p = 0.083) occurred at a similar rate in the elderly and non-elderly groups. After curative ESD, cumulative recurrence rate of the elderly group (0%) did not differ significantly to that of the non-elderly group (5.1%) by the log-rank test (p = 0.307).

Conclusion

ESD for SESCC is effective and safe in elderly patients as in non-elderly patients.

Keywords

Endoscopic submucosal dissection Elderly Esophageal squamous cell carcinoma Outcome 

Notes

Compliance wih ethical standards

Disclosures

Dr. Byeong Geun Song, Yang Won Min, Jun Haeng Lee, Hyuk Lee, Byung-Hoon Min, Poong-Lyul Rhee, and Jae J. Kim have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Byeong Geun Song
    • 1
  • Yang Won Min
    • 1
  • Jun Haeng Lee
    • 1
    Email author
  • Hyuk Lee
    • 1
  • Byung-Hoon Min
    • 1
  • Poong-Lyul Rhee
    • 1
  • Jae J. Kim
    • 1
  1. 1.Department of Medicine, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea

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