title: Long-term prognosis after endoscopic submucosal dissection for early gastric cancer in super-elderly patients.
abstract: No previous study has confirmed the safety of endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) in the super-elderly patient population. The current study aimed to evaluate the validity of ESD for EGC in super-elderly patients aged ≥85 years with comorbidities.
  
  
  
  Our study group included 85 super-elderly patients (102 EGCs) who were diagnosed at Hiroshima University Hospital between April 2002 and October 2014. We evaluated the en bloc resection rates, R0 resection rates, complication rates, and prognosis in relation to the degree of comorbidities (group A-H, patients with high-risk comorbidities; group A-L, patients with low-risk comorbidities; group B, patients without comorbidities; and group C, patients followed without ESD).
  
  
  
  The en bloc resection rates were 100, 96, and 100 % in groups A-H, A-L, and B, respectively. R0 resection rates were 94, 96, and 94 % in groups A-H, A-L, and B, respectively. There were no severe complications related to ESD. During the follow-up period, there was a significantly higher frequency of death in group A than in group B (p < 0.01), and there were no significant differences between groups A-H and A-L. However, there were no cases of death related to gastric cancer.
  
  
  
  ESD was performed safely, and death related to gastric cancer was prevented in super-elderly patients with comorbidities, regardless of the degree of the disease. However, patients with comorbidities are at a high risk of poor prognosis.
authors: Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors: Yoshikazu
authors: Y
authors: Yoshifuku
authors: Department of Endoscopy, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. oka4683@hiroshima-u.ac.jp.
authors: Shiro
authors: S
authors: Oka
authors: Department of Endoscopy, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors: Shinji
authors: S
authors: Tanaka
authors: Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors: Yoji
authors: Y
authors: Sanomura
authors: Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors: Tomohiro
authors: T
authors: Miwata
authors: Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors: Norifumi
authors: N
authors: Numata
authors: Health Service Center, Hiroshima University, Higashihiroshima, Japan.
authors: Toru
authors: T
authors: Hiyama
authors: Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors: Kazuaki
authors: K
authors: Chayama
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D000069916:Endoscopic Mucosal Resection / Q000379:methods*; D004939:Esophageal Perforation / Q000453:epidemiology*; D005260:Female; D005753:Gastric Mucosa / Q000601:surgery*; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000453:epidemiology; D019106:Postoperative Hemorrhage / Q000453:epidemiology*; D011379:Prognosis; D012189:Retrospective Studies; D012306:Risk; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome; D047368:Tumor Burden
keywords: Early gastric cancer; Endoscopic submucosal dissection; Super-elderly patients, comorbidities