Comparison of endoscopic submucosal dissection and surgery for early gastric cancer that is not indicated for endoscopic resection in elderly patients

Kang, Seokin; Lee, Jeong Hoon; Kim, Yuri; Park, Kwangbeom; Na, Hee Kyong; Ahn, Ji Yong; Jung, Kee Wook; Kim, Do Hoon; Choi, Kee Don; Song, Ho June; Lee, Gin Hyug; Jung, Hwoon‐Yong

doi:10.1007/s00464-023-09989-6

Cited by 2 publications

(1 citation statement)

References 29 publications

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“…Some studies reported that the incidence of heterochronous lesions after ESD is higher than that after surgery [ 33 , 35 – 37 ]. Moreover, EGC still carries a risk of lymph node metastasis, and ESD does not allow the removal of potentially metastatic lymph nodes [ 17 – 19 ]. According to the data analysis, we found that the elderly patients with EGC in the ESD group had a worse OS than those in the surgery group.…”

Section: Discussionmentioning

confidence: 99%

Comparison of endoscopic submucosal dissection versus surgery for early gastric cancer in the elderly: a pooled analysis

Liu,

Wen,

Liu

et al. 2023

World J Surg Onc

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Purpose The aim of this study was to investigate whether there was a difference in overall survival (OS) between elderly patients with early gastric cancer (EGC) who underwent endoscopic submucosal dissection (ESD) and those who underwent surgery. Methods Four databases including PubMed, Embase, the Cochrane Library and CKNI were searched on March 20, 2023. The characteristics of the studies and the baseline information of the patients, including their medical histories, postoperative data, and prognoses, were recorded. Odds ratios (ORs) or mean differences (MDs), and 95% confidence intervals (CIs) were pooled up to calculate baseline information and postoperative information. Hazard ratios (HRs) and 95% CIs were used to calculate the prognosis of the patients. Stata V16.0 software was used for the data analysis. Results A total of eight studies involving 2334 patients were included for the data analysis in this study. After pooling up the data, we found that the ESD group had lower Eastern Cooperative Oncology Groupprevious (ECOG) scores (OR = 0.33, 95% CI = 0.17 to 0.65, I2 = 59.69%, P = 0.00 < 0.05) than the surgery group. There were significant differences in the operation time (MD = -3.38, 95% CI = -5.19 to -1.57, I2 = 98.31%, P = 0.00 < 0.05), length of hospital stay (MD = -3.01, 95% CI = -4.81 to -1.20, I2 = 98.83%, P = 0.00 < 0.05) and hospitalization expenses (MD = -2.67, 95% CI = -3.59 to -1.75, I2 = 93.21%, P = 0.00 < 0.05) between the two groups. The ESD group had a lower OS rate (HR = 2.81, 95% CI = 2.20 to 3.58, I2 = 12.28%, P = 0.00 < 0.05). Conclusion Elderly patients with EGC who underwent ESD had a significantly worse OS rate than those who underwent surgery. If the patient’s condition was suitable, surgery was still recommended for these patients.

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Section: Discussionmentioning

confidence: 99%

Comparison of endoscopic submucosal dissection versus surgery for early gastric cancer in the elderly: a pooled analysis

Liu,

Wen,

Liu

et al. 2023

World J Surg Onc

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The Prognostic Role of Prognostic Nutritional Index and Controlling Nutritional Status in Predicting Survival in Older Adults with Oncological Disease: A Systematic Review

Ferreira,

Fernandes,

Carvalho

et al. 2024

Onco

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The increase in new cancer diagnoses in the elderly calls for new, accessible, and easy-to-use prognostic tools that contribute to lowering the burden of the disease. Recognising the importance of inflammation and nutritional status in the progression of the disease, the purpose of this systematic review was to synthesise the evidence on the prognostic role of Prognostic Nutritional Index (PNI) and Controlling Nutritional Status (CONUT) in predicting survival of older adult cancer patients. A comprehensive search was conducted in PubMed and Web of Science Core Collection databases until 22 February 2024. The articles included in this review (n = 38) examined the relationships of PNI and CONUT with survival outcomes in elderly cancer patients. Despite high heterogeneity between the studies, most concluded that low PNI values are associated with poor overall survival (OS), particularly in gastric cancer patients. Most studies did not find an association between PNI and cancer-specific survival, progression-free survival, disease-free survival, recurrence-free survival, and mortality. Results regarding the prognostic role of CONUT in predicting survival were inconclusive. This study suggests that PNI could be used to predict OS in elderly cancer patients, while more studies are needed to assess the prognostic role of CONUT.

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Comparison of endoscopic submucosal dissection and surgery for early gastric cancer that is not indicated for endoscopic resection in elderly patients

Cited by 2 publications

References 29 publications

Comparison of endoscopic submucosal dissection versus surgery for early gastric cancer in the elderly: a pooled analysis

Comparison of endoscopic submucosal dissection versus surgery for early gastric cancer in the elderly: a pooled analysis

The Prognostic Role of Prognostic Nutritional Index and Controlling Nutritional Status in Predicting Survival in Older Adults with Oncological Disease: A Systematic Review

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