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Renal Dysfunction is a Risk Factor of Death after Gastric Endoscopic Submucosal Dissection in Elderly Patients Aged ≥80 Years
INTRODUCTION: Endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) is well accepted. However, its adaptation for elderly patients is unclear. This study aimed to investigate the prognosis and long-term outcomes of ESD for EGC in elderly patients aged ≥80 years by comparing their fin...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6754868/ https://www.ncbi.nlm.nih.gov/pubmed/31583220 http://dx.doi.org/10.1155/2019/7145182 |
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author | Okimoto, Kenichiro Arai, Makoto Ishigami, Hideaki Taida, Takashi Saito, Keiko Maruoka, Daisuke Matsumura, Tomoaki Nakagawa, Tomoo Katsuno, Tatsuro Kato, Naoya |
author_facet | Okimoto, Kenichiro Arai, Makoto Ishigami, Hideaki Taida, Takashi Saito, Keiko Maruoka, Daisuke Matsumura, Tomoaki Nakagawa, Tomoo Katsuno, Tatsuro Kato, Naoya |
author_sort | Okimoto, Kenichiro |
collection | PubMed |
description | INTRODUCTION: Endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) is well accepted. However, its adaptation for elderly patients is unclear. This study aimed to investigate the prognosis and long-term outcomes of ESD for EGC in elderly patients aged ≥80 years by comparing their findings to the findings of patients aged <80 years. MATERIALS AND METHODS: The study included 533 patients (632 lesions). The patients were divided into an elderly group (age, ≥80 years; 108 patients; 128 lesions; mean age, 83.4 ± 2.7 years) and a nonelderly group (age, <80 years; 425 patients; 504 lesions; mean age, 69.6 ± 7.9 years). We compared patient and lesion characteristics, overall survival (OS), and disease-specific survival (DSS) between the 2 groups retrospectively. Multivariate analysis was performed to clarify the risk factors of death after ESD. RESULTS: The rate of curative resection and adverse events was not significantly different between the groups. The mean survival time periods with regard to OS/DSS in the elderly and nonelderly groups were 75.8 ± 5.9 and 122.8 ± 2.6 months (P < 0.05)/120.0 ± 3.0 and 136.4 ± 0.6 months (not significant), respectively. In the elderly group, eGFR <30 ml/min/1.73 m(2) was an independent risk factor of death (hazard ratio = 5.32; 95% confidence interval = 1.39–20.5; P=0.015). CONCLUSION: ESD for EGC can be performed safely and can achieve high curability with good prognosis in elderly patients aged ≥80 years. After ESD, close attention should be paid to elderly patients with severe chronic kidney disease. |
format | Online Article Text |
id | pubmed-6754868 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-67548682019-10-03 Renal Dysfunction is a Risk Factor of Death after Gastric Endoscopic Submucosal Dissection in Elderly Patients Aged ≥80 Years Okimoto, Kenichiro Arai, Makoto Ishigami, Hideaki Taida, Takashi Saito, Keiko Maruoka, Daisuke Matsumura, Tomoaki Nakagawa, Tomoo Katsuno, Tatsuro Kato, Naoya Can J Gastroenterol Hepatol Research Article INTRODUCTION: Endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) is well accepted. However, its adaptation for elderly patients is unclear. This study aimed to investigate the prognosis and long-term outcomes of ESD for EGC in elderly patients aged ≥80 years by comparing their findings to the findings of patients aged <80 years. MATERIALS AND METHODS: The study included 533 patients (632 lesions). The patients were divided into an elderly group (age, ≥80 years; 108 patients; 128 lesions; mean age, 83.4 ± 2.7 years) and a nonelderly group (age, <80 years; 425 patients; 504 lesions; mean age, 69.6 ± 7.9 years). We compared patient and lesion characteristics, overall survival (OS), and disease-specific survival (DSS) between the 2 groups retrospectively. Multivariate analysis was performed to clarify the risk factors of death after ESD. RESULTS: The rate of curative resection and adverse events was not significantly different between the groups. The mean survival time periods with regard to OS/DSS in the elderly and nonelderly groups were 75.8 ± 5.9 and 122.8 ± 2.6 months (P < 0.05)/120.0 ± 3.0 and 136.4 ± 0.6 months (not significant), respectively. In the elderly group, eGFR <30 ml/min/1.73 m(2) was an independent risk factor of death (hazard ratio = 5.32; 95% confidence interval = 1.39–20.5; P=0.015). CONCLUSION: ESD for EGC can be performed safely and can achieve high curability with good prognosis in elderly patients aged ≥80 years. After ESD, close attention should be paid to elderly patients with severe chronic kidney disease. Hindawi 2019-09-09 /pmc/articles/PMC6754868/ /pubmed/31583220 http://dx.doi.org/10.1155/2019/7145182 Text en Copyright © 2019 Kenichiro Okimoto et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Okimoto, Kenichiro Arai, Makoto Ishigami, Hideaki Taida, Takashi Saito, Keiko Maruoka, Daisuke Matsumura, Tomoaki Nakagawa, Tomoo Katsuno, Tatsuro Kato, Naoya Renal Dysfunction is a Risk Factor of Death after Gastric Endoscopic Submucosal Dissection in Elderly Patients Aged ≥80 Years |
title | Renal Dysfunction is a Risk Factor of Death after Gastric Endoscopic Submucosal Dissection in Elderly Patients Aged ≥80 Years |
title_full | Renal Dysfunction is a Risk Factor of Death after Gastric Endoscopic Submucosal Dissection in Elderly Patients Aged ≥80 Years |
title_fullStr | Renal Dysfunction is a Risk Factor of Death after Gastric Endoscopic Submucosal Dissection in Elderly Patients Aged ≥80 Years |
title_full_unstemmed | Renal Dysfunction is a Risk Factor of Death after Gastric Endoscopic Submucosal Dissection in Elderly Patients Aged ≥80 Years |
title_short | Renal Dysfunction is a Risk Factor of Death after Gastric Endoscopic Submucosal Dissection in Elderly Patients Aged ≥80 Years |
title_sort | renal dysfunction is a risk factor of death after gastric endoscopic submucosal dissection in elderly patients aged ≥80 years |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6754868/ https://www.ncbi.nlm.nih.gov/pubmed/31583220 http://dx.doi.org/10.1155/2019/7145182 |
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