title: Long-term outcomes of colorectal endoscopic submucosal dissection in elderly patients.
abstract: OBJECTIVE
  The safety and efficacy of endoscopic submucosal dissection (ESD) in elderly patients remain unclear. The aim of this study is to clarify the short- and long-term outcomes of colorectal ESD in elderly patients.
  
  
  METHODS
  A total of 482 consecutive patients with 501 colorectal lesions treated with ESD from February 2005 to December 2013 were retrospectively reviewed. Patients were divided into two groups: an elderly group (≥ 75 years of age) and a non-elderly group (< 75 years of age). Short-term outcomes of interest were procedure time, complication rate, hospital stay, en bloc resection rate, and non-curative resection rate. Long-term outcomes of interest were disease-specific survival, and overall survival rates in the elderly group (51 patients) and non-elderly group (92 patients) were also analyzed.
  
  
  RESULTS
  No significant differences were observed between the groups with respect to short-term outcomes. Two patients in each group required emergency surgery. Of the patients who underwent non-curative resection, 7/12 (58%) in the elderly group and 15/23 (65%) in the non-elderly group underwent additional surgery. The 5-year disease-specific survival rates in the elderly and non-elderly groups were both 100%, and the corresponding 5-year overall survival rates were 86.3 and 93.5%, respectively (p = 0.026).
  
  
  CONCLUSIONS
  Short-term outcomes after colorectal ESD were equivalent in both groups, and all patients showed favorable long-term outcomes. Considering the benign prognosis of lesions resected with ESD, preoperative screening of comorbidities is essential to improve overall survival.
authors.affiliation: Graduate School of Medical and Dental Science, Department of Gastroenterology and Hepatology, Niigata University, 757-1, Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan. ytty0125ytty@yahoo.co.jp.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: Graduate School of Medical and Dental Science, Department of Gastroenterology and Hepatology, Niigata University, 757-1, Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan.
authors.forename: Ken-Ichi
authors.initials: KI
authors.lastname: Mizuno
authors.affiliation: Graduate School of Medical and Dental Science, Department of Gastroenterology and Hepatology, Niigata University, 757-1, Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Graduate School of Medical and Dental Science, Department of Gastroenterology and Hepatology, Niigata University, 757-1, Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Sato
authors.affiliation: Graduate School of Medical and Dental Science, Department of Gastroenterology and Hepatology, Niigata University, 757-1, Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Hashimoto
authors.affiliation: Department of Gastroenterology and Hepatology, Nagaoka Red Cross Hospital, Nagaoka, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Takeuchi
authors.affiliation: Department of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kobayashi
authors.affiliation: Graduate School of Medical and Dental Science, Department of Gastroenterology and Hepatology, Niigata University, 757-1, Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Yokoyama
authors.affiliation: Graduate School of Medical and Dental Science, Department of Gastroenterology and Hepatology, Niigata University, 757-1, Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Graduate School of Medical and Dental Science, Department of Gastroenterology and Hepatology, Niigata University, 757-1, Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Terai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D004210:Dissection; D000069916:Endoscopic Mucosal Resection; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery*; D008297:Male; D013997:Time Factors; D016896:Treatment Outcome
keywords: Colorectal cancer; Elderly; Endoscopic submucosal dissection