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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...

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Autores principales: Okimoto, Kenichiro, Arai, Makoto, Ishigami, Hideaki, Taida, Takashi, Saito, Keiko, Maruoka, Daisuke, Matsumura, Tomoaki, Nakagawa, Tomoo, Katsuno, Tatsuro, Kato, Naoya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2019
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.
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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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