Endoscopic submucosal dissection for superficial esophageal neoplasms in elderly patients: A single-center, large-scale, retrospective study

Geriatr Gerontol Int. 2020 May;20(5):430-435. doi: 10.1111/ggi.13892. Epub 2020 Mar 4.

Abstract

Aim: The number of elderly patients with superficial esophageal neoplasms has steadily increased, but few studies have focused on the clinical outcomes of esophageal endoscopic submucosal dissection in these patients. Therefore, the aim of our study was to investigate the feasibility and safety of endoscopic submucosal dissection among elderly patients with superficial esophageal neoplasms.

Methods: Patients who underwent endoscopic submucosal dissection for superficial esophageal neoplasms between December 2005 and December 2017 were eligible. The patients were divided into two groups according to age: Not-old (<75 years, n = 369) and Old (≥75 years, n = 44). Clinical features and treatment outcomes were retrospectively investigated by reviewing medical records.

Results: In total, 413 patients with 459 lesions were enrolled in to this study. Comorbidities, except for a previous history of malignancy, were not significantly different between the two groups. Procedure-related characteristics and the rate of adverse events were similar in the two groups. During a median follow-up period of 33.4 months, the overall survival rate was lower in the Old group (P = 0.046), and the cumulative recurrence rate did not differ significantly between the two groups (P = 0.334).

Conclusion: Based on these favorable outcomes, endoscopic submucosal dissection is as feasible and effective for the treatment of superficial esophageal neoplasms among elderly patients as it is among non-elderly patients. Geriatr Gerontol Int 2020; 20: 430-435.

Keywords: antithrombotic agents; comorbidity; elderly; endoscopic submucosal dissection; esophageal neoplasm.

MeSH terms

  • Aged
  • Carcinoma, Squamous Cell / mortality*
  • Carcinoma, Squamous Cell / surgery*
  • Endoscopic Mucosal Resection*
  • Esophageal Neoplasms / mortality*
  • Esophageal Neoplasms / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Republic of Korea
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome