Long-term outcomes after endoscopic resection for late-elderly patients with early gastric cancer
With the population aging, the incidence of early gastric cancer (EGC) is increasing. We aimed to clarify the indications for endoscopic resection (ER) in late-elderly patients with EGC in terms of life expectancy. Patients aged ≥75 years who underwent ER for EGC at our institution from January 2007...
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| Veröffentlicht in: | Gastrointestinal endoscopy 2022-05, Vol.95 (5), p.873-883 |
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| creator | Waki, Kotaro Shichijo, Satoki Uedo, Noriya Takeuchi, Yoshinori Maekawa, Akira Kanesaka, Takashi Takeuchi, Yoji Higashino, Koji Ishihara, Ryu Tanaka, Yasuhito Michida, Tomoki |
| description | With the population aging, the incidence of early gastric cancer (EGC) is increasing. We aimed to clarify the indications for endoscopic resection (ER) in late-elderly patients with EGC in terms of life expectancy.
Patients aged ≥75 years who underwent ER for EGC at our institution from January 2007 to December 2012 were enrolled. Clinical data, including Eastern Cooperative Oncology Group performance status (ECOG-PS), Charlson comorbidity index, and Prognostic Nutritional Index (PNI), were collected at the time of ER. Overall survival (OS) was the main outcome measure.
Four hundred consecutive patients were enrolled. Mean patient age was 79.3 years (range, 75-93). The 5-year follow-up rate was 89.0% (median follow-up period, 5.6 years). Five-year OS was 80.8% (95% confidence interval [CI], 76.4-84.4), and 5-year net survival standardized for age, sex, and calendar year was 1.09 (95% CI, 1.03-1.15). With a multivariate analysis, ECOG-PS 2 to 4 (hazard ratio, 8.84; 95% CI, 3.07-25.4), PNI |
| doi_str_mv | 10.1016/j.gie.2021.12.028 |
| format | Article |
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Patients aged ≥75 years who underwent ER for EGC at our institution from January 2007 to December 2012 were enrolled. Clinical data, including Eastern Cooperative Oncology Group performance status (ECOG-PS), Charlson comorbidity index, and Prognostic Nutritional Index (PNI), were collected at the time of ER. Overall survival (OS) was the main outcome measure.
Four hundred consecutive patients were enrolled. Mean patient age was 79.3 years (range, 75-93). The 5-year follow-up rate was 89.0% (median follow-up period, 5.6 years). Five-year OS was 80.8% (95% confidence interval [CI], 76.4-84.4), and 5-year net survival standardized for age, sex, and calendar year was 1.09 (95% CI, 1.03-1.15). With a multivariate analysis, ECOG-PS 2 to 4 (hazard ratio, 8.84; 95% CI, 3.07-25.4), PNI <49.1 (hazard ratio, 2.49; 95% CI, 1.53-4.06), and eCura C-2 (hazard ratio, 1.79; 95% CI, 1.11-2.88) were independent prognostic factors. When none of these factors was met, the 5-year OS rate was 90.4% (95% CI, 84.0-94.3).
ER for EGC in late-elderly patients may improve life expectancy. ER is recommended in patients with a good ECOG-PS and PNI and in whom ER is expected to be non-eCura C-2.</description><identifier>ISSN: 0016-5107</identifier><identifier>EISSN: 1097-6779</identifier><identifier>DOI: 10.1016/j.gie.2021.12.028</identifier><identifier>PMID: 34979116</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Endoscopic Mucosal Resection ; Endoscopy ; Humans ; Prognosis ; Retrospective Studies ; Stomach Neoplasms - epidemiology ; Stomach Neoplasms - surgery ; Treatment Outcome</subject><ispartof>Gastrointestinal endoscopy, 2022-05, Vol.95 (5), p.873-883</ispartof><rights>2022 American Society for Gastrointestinal Endoscopy</rights><rights>Copyright © 2022 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c353t-5523df2ed9a1d2b99d54b54f2bb23a09bf99a989581df6fc7759c8d4f22f7aeb3</citedby><cites>FETCH-LOGICAL-c353t-5523df2ed9a1d2b99d54b54f2bb23a09bf99a989581df6fc7759c8d4f22f7aeb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.gie.2021.12.028$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,782,786,3554,27933,27934,46004</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34979116$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Waki, Kotaro</creatorcontrib><creatorcontrib>Shichijo, Satoki</creatorcontrib><creatorcontrib>Uedo, Noriya</creatorcontrib><creatorcontrib>Takeuchi, Yoshinori</creatorcontrib><creatorcontrib>Maekawa, Akira</creatorcontrib><creatorcontrib>Kanesaka, Takashi</creatorcontrib><creatorcontrib>Takeuchi, Yoji</creatorcontrib><creatorcontrib>Higashino, Koji</creatorcontrib><creatorcontrib>Ishihara, Ryu</creatorcontrib><creatorcontrib>Tanaka, Yasuhito</creatorcontrib><creatorcontrib>Michida, Tomoki</creatorcontrib><title>Long-term outcomes after endoscopic resection for late-elderly patients with early gastric cancer</title><title>Gastrointestinal endoscopy</title><addtitle>Gastrointest Endosc</addtitle><description>With the population aging, the incidence of early gastric cancer (EGC) is increasing. We aimed to clarify the indications for endoscopic resection (ER) in late-elderly patients with EGC in terms of life expectancy.
Patients aged ≥75 years who underwent ER for EGC at our institution from January 2007 to December 2012 were enrolled. Clinical data, including Eastern Cooperative Oncology Group performance status (ECOG-PS), Charlson comorbidity index, and Prognostic Nutritional Index (PNI), were collected at the time of ER. Overall survival (OS) was the main outcome measure.
Four hundred consecutive patients were enrolled. Mean patient age was 79.3 years (range, 75-93). The 5-year follow-up rate was 89.0% (median follow-up period, 5.6 years). Five-year OS was 80.8% (95% confidence interval [CI], 76.4-84.4), and 5-year net survival standardized for age, sex, and calendar year was 1.09 (95% CI, 1.03-1.15). With a multivariate analysis, ECOG-PS 2 to 4 (hazard ratio, 8.84; 95% CI, 3.07-25.4), PNI <49.1 (hazard ratio, 2.49; 95% CI, 1.53-4.06), and eCura C-2 (hazard ratio, 1.79; 95% CI, 1.11-2.88) were independent prognostic factors. When none of these factors was met, the 5-year OS rate was 90.4% (95% CI, 84.0-94.3).
ER for EGC in late-elderly patients may improve life expectancy. ER is recommended in patients with a good ECOG-PS and PNI and in whom ER is expected to be non-eCura C-2.</description><subject>Aged</subject><subject>Endoscopic Mucosal Resection</subject><subject>Endoscopy</subject><subject>Humans</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Stomach Neoplasms - epidemiology</subject><subject>Stomach Neoplasms - surgery</subject><subject>Treatment Outcome</subject><issn>0016-5107</issn><issn>1097-6779</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1LAzEQhoMotlZ_gBfJ0cuuSbbZ3eBJil9Q8KLnkE0mNWV3U5NU6b83perR0zDD874wD0KXlJSU0PpmXa4clIwwWlJWEtYeoSkloinqphHHaEoyVHBKmgk6i3FNCGlZRU_RpJqLRlBaT5Fa-nFVJAgD9tuk_QARK5t3DKPxUfuN0zhABJ2cH7H1AfcqQQG9gdDv8EYlB2OK-Muldwxqf1upmEKOaTVqCOfoxKo-wsXPnKG3h_vXxVOxfHl8XtwtC13xKhWcs8pYBkYoalgnhOHzjs8t6zpWKSI6K4QSreAtNba2umm40K3JALONgq6aoetD7yb4jy3EJAcXNfS9GsFvo2Q1rWtStXyeUXpAdfAxBrByE9ygwk5SIvdm5Vpms3JvVlIms9mcufqp33YDmL_Er8oM3B4AyE9-Oggy6qxGg3Eh25PGu3_qvwGOM4sF</recordid><startdate>20220501</startdate><enddate>20220501</enddate><creator>Waki, Kotaro</creator><creator>Shichijo, Satoki</creator><creator>Uedo, Noriya</creator><creator>Takeuchi, Yoshinori</creator><creator>Maekawa, Akira</creator><creator>Kanesaka, Takashi</creator><creator>Takeuchi, Yoji</creator><creator>Higashino, Koji</creator><creator>Ishihara, Ryu</creator><creator>Tanaka, Yasuhito</creator><creator>Michida, Tomoki</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20220501</creationdate><title>Long-term outcomes after endoscopic resection for late-elderly patients with early gastric cancer</title><author>Waki, Kotaro ; Shichijo, Satoki ; Uedo, Noriya ; Takeuchi, Yoshinori ; Maekawa, Akira ; Kanesaka, Takashi ; Takeuchi, Yoji ; Higashino, Koji ; Ishihara, Ryu ; Tanaka, Yasuhito ; Michida, Tomoki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c353t-5523df2ed9a1d2b99d54b54f2bb23a09bf99a989581df6fc7759c8d4f22f7aeb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Aged</topic><topic>Endoscopic Mucosal Resection</topic><topic>Endoscopy</topic><topic>Humans</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Stomach Neoplasms - epidemiology</topic><topic>Stomach Neoplasms - surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Waki, Kotaro</creatorcontrib><creatorcontrib>Shichijo, Satoki</creatorcontrib><creatorcontrib>Uedo, Noriya</creatorcontrib><creatorcontrib>Takeuchi, Yoshinori</creatorcontrib><creatorcontrib>Maekawa, Akira</creatorcontrib><creatorcontrib>Kanesaka, Takashi</creatorcontrib><creatorcontrib>Takeuchi, Yoji</creatorcontrib><creatorcontrib>Higashino, Koji</creatorcontrib><creatorcontrib>Ishihara, Ryu</creatorcontrib><creatorcontrib>Tanaka, Yasuhito</creatorcontrib><creatorcontrib>Michida, Tomoki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Gastrointestinal endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Waki, Kotaro</au><au>Shichijo, Satoki</au><au>Uedo, Noriya</au><au>Takeuchi, Yoshinori</au><au>Maekawa, Akira</au><au>Kanesaka, Takashi</au><au>Takeuchi, Yoji</au><au>Higashino, Koji</au><au>Ishihara, Ryu</au><au>Tanaka, Yasuhito</au><au>Michida, Tomoki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term outcomes after endoscopic resection for late-elderly patients with early gastric cancer</atitle><jtitle>Gastrointestinal endoscopy</jtitle><addtitle>Gastrointest Endosc</addtitle><date>2022-05-01</date><risdate>2022</risdate><volume>95</volume><issue>5</issue><spage>873</spage><epage>883</epage><pages>873-883</pages><issn>0016-5107</issn><eissn>1097-6779</eissn><abstract>With the population aging, the incidence of early gastric cancer (EGC) is increasing. We aimed to clarify the indications for endoscopic resection (ER) in late-elderly patients with EGC in terms of life expectancy.
Patients aged ≥75 years who underwent ER for EGC at our institution from January 2007 to December 2012 were enrolled. Clinical data, including Eastern Cooperative Oncology Group performance status (ECOG-PS), Charlson comorbidity index, and Prognostic Nutritional Index (PNI), were collected at the time of ER. Overall survival (OS) was the main outcome measure.
Four hundred consecutive patients were enrolled. Mean patient age was 79.3 years (range, 75-93). The 5-year follow-up rate was 89.0% (median follow-up period, 5.6 years). Five-year OS was 80.8% (95% confidence interval [CI], 76.4-84.4), and 5-year net survival standardized for age, sex, and calendar year was 1.09 (95% CI, 1.03-1.15). With a multivariate analysis, ECOG-PS 2 to 4 (hazard ratio, 8.84; 95% CI, 3.07-25.4), PNI <49.1 (hazard ratio, 2.49; 95% CI, 1.53-4.06), and eCura C-2 (hazard ratio, 1.79; 95% CI, 1.11-2.88) were independent prognostic factors. When none of these factors was met, the 5-year OS rate was 90.4% (95% CI, 84.0-94.3).
ER for EGC in late-elderly patients may improve life expectancy. ER is recommended in patients with a good ECOG-PS and PNI and in whom ER is expected to be non-eCura C-2.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>34979116</pmid><doi>10.1016/j.gie.2021.12.028</doi><tpages>11</tpages></addata></record> |
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| subjects | Aged Endoscopic Mucosal Resection Endoscopy Humans Prognosis Retrospective Studies Stomach Neoplasms - epidemiology Stomach Neoplasms - surgery Treatment Outcome |
| title | Long-term outcomes after endoscopic resection for late-elderly patients with early gastric cancer |
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