| Theme | Endoscopic Treatment for Elderly Patients with Gastro‒intestinal Cancer | |
|---|---|---|
| Title | Status of Endoscopic Submucosal Dissection for Gastric Cancer | |
| Publish Date | 2017/06 | |
| Author | Yorimasa Yamamoto | Division of Gastroenterological Internal Medicine, Cancer Institute Hospital / Department of Gastroenterology, Showa University Fujigaoka Hospital |
| Author | Yusuke Horiuchi | Division of Gastroenterological Internal Medicine, Cancer Institute Hospital |
| Author | Toshiyuki Yoshio | Division of Gastroenterological Internal Medicine, Cancer Institute Hospital |
| Author | Toshiaki Hirasawa | Division of Gastroenterological Internal Medicine, Cancer Institute Hospital |
| Author | Akiyoshi Ishiyama | Division of Gastroenterological Internal Medicine, Cancer Institute Hospital |
| Author | Junko Fujisaki | Division of Gastroenterological Internal Medicine, Cancer Institute Hospital |
| [ Summary ] | The high incidence of gastric cancer in Japan is primarily due to an aging population. The rate of elderly patients has been increased especially. Endoscopic submucosal dissection (ESD) for early gastric cancer would be useful and widely adapted to elderly patients because it is a minimally invasive technique. However, elderly patients with comorbidities would not be good candidates for ESD because ESD would not affect the survival rate of such patients. Elderly patients undergoing ESD require close careful monitoring because their vital signs are often unstable during the procedure. Additional surgery is recommended even in an elderly patient whose histological finding after ESD is non‒curative. The indication for additional surgery in this age group must be determined only after fully considering the risks of operation and lymph node metastasis. The treatment strategy must be determined considering the patient's general health state because elderly patients have many influencing factors in addition to age. | |