Treatment of early gastric cancer in the elderly patient

Results of EMR and gastrectomy at a national referral center in Japan

Tsuyoshi Etoh, Hitoshi Katai, Takeo Fukagawa, Takeshi Sano, Ichiro Oda, Takuji Gotoda, Kimio Yoshimura, Mitsuru Sasako

Research output: Contribution to journalArticle

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Abstract

Background: The Japanese population is rapidly aging, and the actual number of elderly patients with gastric cancer, including early cancer, has been increasing, even though the standardized incidence of gastric cancer in the population is decreasing. The optimal treatment for these patients remains a challenge to the surgeon. The aim of this retrospective analysis was to describe the results of gastrectomy and EMR for early gastric cancer in elderly patients (80 years of age and over). Methods: This is a retrospective review of 93 elderly patients who had undergone gastrectomy or EMR at the National Cancer Center Hospital for early gastric cancer. EMR was performed aiming en bloc local resection with a clear curative margin (R0). The clinicopathologic characteristics, comorbidity, postoperative mortality, and outcome were recorded. Results: Gastrectomy was performed in 44 patients (surgery group) and EMR in 49 patients (EMR group). There were significant differences in mean tumor size (p < 0.05), histologic type (p < 0.05), and depth of tumor invasion (p < 0.05) between the two groups. There was no significant difference in comorbidity between the two groups. No operative death was reported in either group. In the EMR group, 7 patients were reported to have recurrence of local disease and two patients died of advanced disease. There were no significant differences in the overall 3-year survival rate or the 5-year survival rate between the surgery group and EMR group (73.5% vs. 82.5% and 55.0% vs. 62.5%, respectively). Conclusions: EMR (R0) resection was performed safely in the elderly, and the overall results were excellent, the same as the results with gastrectomy. Gastrectomy can still be performed if EMR is unsuccessful.

Original languageEnglish
Pages (from-to)868-871
Number of pages4
JournalGastrointestinal Endoscopy
Volume62
Issue number6
DOIs
Publication statusPublished - 2005 Dec
Externally publishedYes

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Gastrectomy
Stomach Neoplasms
Japan
Referral and Consultation
Therapeutics
Comorbidity
Survival Rate
Cancer Care Facilities
Neoplasms
Population
Recurrence
Mortality
Incidence

ASJC Scopus subject areas

  • Gastroenterology

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Treatment of early gastric cancer in the elderly patient : Results of EMR and gastrectomy at a national referral center in Japan. / Etoh, Tsuyoshi; Katai, Hitoshi; Fukagawa, Takeo; Sano, Takeshi; Oda, Ichiro; Gotoda, Takuji; Yoshimura, Kimio; Sasako, Mitsuru.

In: Gastrointestinal Endoscopy, Vol. 62, No. 6, 12.2005, p. 868-871.

Research output: Contribution to journalArticle

Etoh, Tsuyoshi ; Katai, Hitoshi ; Fukagawa, Takeo ; Sano, Takeshi ; Oda, Ichiro ; Gotoda, Takuji ; Yoshimura, Kimio ; Sasako, Mitsuru. / Treatment of early gastric cancer in the elderly patient : Results of EMR and gastrectomy at a national referral center in Japan. In: Gastrointestinal Endoscopy. 2005 ; Vol. 62, No. 6. pp. 868-871.
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T2 - Results of EMR and gastrectomy at a national referral center in Japan

AU - Etoh, Tsuyoshi

AU - Katai, Hitoshi

AU - Fukagawa, Takeo

AU - Sano, Takeshi

AU - Oda, Ichiro

AU - Gotoda, Takuji

AU - Yoshimura, Kimio

AU - Sasako, Mitsuru

PY - 2005/12

Y1 - 2005/12

N2 - Background: The Japanese population is rapidly aging, and the actual number of elderly patients with gastric cancer, including early cancer, has been increasing, even though the standardized incidence of gastric cancer in the population is decreasing. The optimal treatment for these patients remains a challenge to the surgeon. The aim of this retrospective analysis was to describe the results of gastrectomy and EMR for early gastric cancer in elderly patients (80 years of age and over). Methods: This is a retrospective review of 93 elderly patients who had undergone gastrectomy or EMR at the National Cancer Center Hospital for early gastric cancer. EMR was performed aiming en bloc local resection with a clear curative margin (R0). The clinicopathologic characteristics, comorbidity, postoperative mortality, and outcome were recorded. Results: Gastrectomy was performed in 44 patients (surgery group) and EMR in 49 patients (EMR group). There were significant differences in mean tumor size (p < 0.05), histologic type (p < 0.05), and depth of tumor invasion (p < 0.05) between the two groups. There was no significant difference in comorbidity between the two groups. No operative death was reported in either group. In the EMR group, 7 patients were reported to have recurrence of local disease and two patients died of advanced disease. There were no significant differences in the overall 3-year survival rate or the 5-year survival rate between the surgery group and EMR group (73.5% vs. 82.5% and 55.0% vs. 62.5%, respectively). Conclusions: EMR (R0) resection was performed safely in the elderly, and the overall results were excellent, the same as the results with gastrectomy. Gastrectomy can still be performed if EMR is unsuccessful.

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