Clinical impact of evaluation of frailty in endoscopic submucosal dissection for early gastric cancer in elderly patients

Aims Endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) is performed safely and effectively in elderly patients; however, whether ESD for EGC in elderly patients with frailty is safe and improves prognosis remains unclear. Methods In total, 142 patients aged ≥80 years who underwent ESD for EGC between September 2008 and September 2014 were included. We compared outcomes between patients with frailty and those without frailty. Frailty was assessed using the Clinical Frailty Scale (CFS) based on a patient's status before admission. Study endpoints were short‐ and long‐term clinical outcomes after ESD. Results Patients were allocated into two groups: no frailty (CFS 1–3, n = 101) versus frailty (CFS 4–7, n = 41). Short‐term clinical outcomes, specifically, adverse events and curability, did not differ between the two groups. For the long‐term clinical outcomes, patients with frailty had significantly worse outcomes after ESD than those without frailty (the 3‐year overall survival rates were 73.2% vs. 93.1%; P