title: Short- and long-term outcomes of endoscopic submucosal dissection for early gastric cancer in elderly patients aged 75 years and older.
abstract: BACKGROUND
  Only a few studies have reported long-term outcomes for endoscopic submucosal dissection (ESD) of early gastric cancer (EGC) in elderly patients. The aim of this study was to evaluate the efficacy of ESD for EGC in elderly patients ≥75 years with respect to both short- and long-term outcomes.
  
  
  METHODS
  We reviewed the clinical data of elderly patients ≥75 years who had undergone ESD for EGC at Tonan Hospital from January 2003 to May 2010.
  
  
  RESULTS
  A total of 177 consecutive patients, including 145 with curative resection (CR) and 32 with noncurative resection (non-CR), were examined. Of the 32 patients with non-CR, 15 underwent additional surgery, and lymph node metastases were found in 3 patients. The remaining 17 patients were followed without additional surgery because of advanced age or poor general condition. Procedure-related complications, such as post-ESD bleeding, perforation and pneumonia, were within the acceptable range. The 5-year survival rates of patients with CR, those with additional surgery after non-CR, and those without additional surgery after non-CR were 84.6, 73.3, and 58.8 %, respectively. No deaths were attributable to the original gastric cancer; patients succumbed to other illnesses, including malignancy and respiratory disease.
  
  
  CONCLUSIONS
  In elderly patients, ESD is an acceptable treatment for EGC in terms of both short- and long-term outcomes. Careful clinical assessment of elderly patients is necessary before ESD. After ESD, medical follow-up is important so that other malignancies and diseases that affect the elderly are not overlooked.
authors.affiliation: Department of Gastroenterology, Tonan Hospital, Kita 1, Nishi 6, Chuo-ku, Sapporo, Hokkaido, 060-0001, Japan. t-sumiyoshi@tonan.gr.jp.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Sumiyoshi
authors.affiliation: Department of Gastroenterology, Tonan Hospital, Kita 1, Nishi 6, Chuo-ku, Sapporo, Hokkaido, 060-0001, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kondo
authors.affiliation: Department of Gastroenterology, Tonan Hospital, Kita 1, Nishi 6, Chuo-ku, Sapporo, Hokkaido, 060-0001, Japan.
authors.forename: Ryoji
authors.initials: R
authors.lastname: Fujii
authors.affiliation: Department of Gastroenterology, Tonan Hospital, Kita 1, Nishi 6, Chuo-ku, Sapporo, Hokkaido, 060-0001, Japan.
authors.forename: Takeyoshi
authors.initials: T
authors.lastname: Minagawa
authors.affiliation: Department of Gastroenterology, Tonan Hospital, Kita 1, Nishi 6, Chuo-ku, Sapporo, Hokkaido, 060-0001, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Fujie
authors.affiliation: Department of Gastroenterology, Tonan Hospital, Kita 1, Nishi 6, Chuo-ku, Sapporo, Hokkaido, 060-0001, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kimura
authors.affiliation: Department of Gastroenterology, Tonan Hospital, Kita 1, Nishi 6, Chuo-ku, Sapporo, Hokkaido, 060-0001, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Ihara
authors.affiliation: Department of Gastroenterology, Tonan Hospital, Kita 1, Nishi 6, Chuo-ku, Sapporo, Hokkaido, 060-0001, Japan.
authors.forename: Naohito
authors.initials: N
authors.lastname: Yoshizaki
authors.affiliation: Department of Gastroenterology, Tonan Hospital, Kita 1, Nishi 6, Chuo-ku, Sapporo, Hokkaido, 060-0001, Japan.
authors.forename: Michiaki
authors.initials: M
authors.lastname: Hirayama
authors.affiliation: Department of Pathology, Tonan Hospital, Kita 1, Nishi 6, Chuo-ku, Sapporo, Hokkaido, 060-0001, Japan.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Oyamada
authors.affiliation: Department of Surgery, Tonan Hospital, Kita 1, Nishi 6, Chuo-ku, Sapporo, Hokkaido, 060-0001, Japan.
authors.forename: Shunichi
authors.initials: S
authors.lastname: Okushiba
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000069916:Endoscopic Mucosal Resection / Q000009:adverse effects / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Early gastric cancer; Elderly; Endoscopic submucosal dissection (ESD)