| Theme |
Gastrointestinal Disease in the Elderly Focusing on Minimally Invasive Therapy |
| Title |
Indications for EMR of Early Gastric Cancer in Elderly Patients |
| Author |
Eriko Masuda |
Departments of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases |
| Author |
Noriya Uedo |
Departments of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases |
| Author |
Hiroyasu Iishi |
Departments of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases |
| Author |
Hideaki Tsukuma |
Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases |
| Author |
Shingo Ishiguro |
Pathology, Osaka Medical Center for Cancer and Cardiovascular Diseases |
| [ Summary ] |
In respect to decreased invasiveness, endoscopic mucosal resection (EMR) is sometimes performed on elderly patients with early gastric cancer (EGC) unless the lesions are not indicated for EMR. To investigate the results of over-indicating EMR for patients with EGC, long-term prognosis of 345 patients who underwent EMR for EGC with the strip biopsy method were analyzed, and were compared to those of 35 untreated EGC patients. The prognosis of patients with EGC that did not fulfill the indication criteria ( ≤ 2 cm differentiated type mucosal EGC without ulceration or scars) was significantly worse than that of patients with EGC who fulfilled the indications and was similar to that of untreated patients. The overall survival rate of patients older than 85 with EGC that fullfiled the indications for EMR, was inferior to that of untreated patients because of morbidity from causes other than gastric cancer. The results from non-concurrent controled studies of retrospective cohort, suggested that over-indication for EMR is not efficacious in patients with EGC. The indications for EMR should be assessed carefully regarding complications in the oldest patients with EGC. |