It is time to tailor endoscopic resection for early gastric cancer: Evaluate not only lesion but also patient

Abe, Seiichiro; Sekiguchi, Masau

doi:10.1111/den.14271

Cited by 1 publication

(2 citation statements)

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“…reported that only approximately 20% of patients aged over 80 years and approximately 50% of those aged over 70 years undergo additional surgery, and no difference in disease‐specific survival or OS is observed between the follow‐up and additional‐surgery groups among patients aged over 80 years 24 . In recent years, tailor‐made treatment strategies have been initiated for the treatment of elderly patients with gastric cancer, based on previous reports 34–36 . This study showed that the 5‐year OS rate for patients with three factors was only 10.0%.…”

Section: Discussionmentioning

confidence: 69%

“…24 In recent years, tailor-made treatment strategies have been initiated for the treatment of elderly patients with gastric cancer, based on previous reports. [34][35][36] This study showed that the 5-year OS rate for patients with three factors was only 10.0%. Thus, for elderly patients over 80 years old with low skeletal muscle mass and many comorbidities, neither additional surgical resection in cases of noncurative resection nor ESD is likely to contribute to prognosis.…”

Section: Discussionmentioning

confidence: 75%

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Scoring system for predicting the prognosis of elderly gastric cancer patients after endoscopic submucosal dissection

Ito

Funasaka

Fujiyoshi

et al. 2022

Digestive Endoscopy

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Objectives: Comprehensive assessments of the long-term outcomes of endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) in the elderly are unavailable. We aimed to create a scoring system to predict the long-term prognosis after ESD for EGC among patients aged ≥75 years. Methods:We conducted retrospective studies of two cohorts: a single-center cohort (2006)(2007)(2008)(2009)(2010)(2011) for developing the scoring system, and a multicenter cohort for validating the developed system (2012-2016). In the development cohort, factors related to death after ESD were identified using multivariable Cox regression analysis, and a predictive scoring system was developed. In the validation cohort, the scoring system was validated in 295 patients.Results: In the development cohort, Charlson comorbidity index (CCI) ≥3 (hazard ratio [HR] 3.017), high psoas muscle index (PMI) (HR 2.206), and age ≥80 years (HR 1.978) were significantly related to overall survival after ESD. Therefore, high CCI, low PMI, and age ≥80 years were assigned 1 point each. The patients were categorized into low (≤1 point) and high (≥2 points) score groups based on their total scores. In the validation cohort, 184 and 111 patients were assigned to the low-and high-score groups, respectively. In comparisons based on Kaplan-Meier curves, the 5-year survival rate was 91.5% in the low-score group and 57.8% in the high-score group (log-rank test; P < 0.001). Conclusion:Our scoring system including high CCI, low PMI, and age ≥80 years could stratify the long-term prognosis of elderly patients aged ≥75 years after ESD for EGC.

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Section: Discussionmentioning

confidence: 69%