| Theme | Endoscopic Treatment for Elderly Patients with Gastro‒intestinal Cancer | |
|---|---|---|
| Title | Current State of Endoscopic Treatment for the Aged Population | |
| Publish Date | 2017/06 | |
| Author | Kazuya Inoki | Endoscopy Division, National Cancer Center Hospital |
| Author | Yutaka Saito | Endoscopy Division, National Cancer Center Hospital |
| Author | Masayoshi Yamada | Endoscopy Division, National Cancer Center Hospital |
| Author | Taku Sakamoto | Endoscopy Division, National Cancer Center Hospital |
| Author | Takeshi Nakajima | Endoscopy Division, National Cancer Center Hospital |
| Author | Takahisa Matsuda | Endoscopy Division, National Cancer Center Hospital |
| [ Summary ] | Japan is an aging society, and it is estimated that the elderly population in Japan will increase further. As the number of elderly people increases, the prevalence of colorectal cancer will also increase. Thus, endoscopic treatment has a useful role as a minimally invasive treatment in elderly patients. It is difficult to determine treatment strategies based only on the patient's age because the general condition of elderly patients is variable. Therefore, a treatment strategy must be chosen according to prognosis and general condition of the elderly patient. If the patient's general condition is excellent and prognosis is good, treatment with curative intent should be planned. Furthermore, en‒bloc resection is better to lengthen the surveillance interval. Efficacy and safety of endoscopic submucosal dissection (ESD) for elders has been established, ESD should be performed by well‒experienced endoscopists considering that elderly patients are highly vulnerable to complications. In case of non‒curative resection, the decision to perform additional surgery should be made carefully in view of possible lymph node metastasis and perioperative risks. | |