Korean J Gastroenterol.  2022 Jul;80(1):1-5. 10.4166/kjg.2022.084.

Endoscopic Resection of Early Gastric Cancer in Elderly

• Jung DH

• KMID: 2532161
• DOI: http://doi.org/10.4166/kjg.2022.084

Abstract

With the aging of the society, the proportion of elderly patients with gastric cancer is increasing and the chances of encountering elderly patients with early gastric cancer (EGC) are increasing. Because elderly patients have more comorbidities, and lower life expectancy than younger patients, the treatment strategy for elderly patients with EGC is not standardized. Therefore, it is necessary to identify risk factors related to survival of elderly patients with EGC and to establish treatment strategies according to prognosis in elderly patients with EGC.

Keyword

Stomach neoplasms; Aged; Endoscopy

Reference

1. Jung KW, Won YJ, Kang MJ, Kong HJ, Im JS, Seo HG. 2022; Prediction of cancer incidence and mortality in Korea, 2022. Cancer Res Treat. 54:345–351. DOI: 10.4143/crt.2022.179. PMID: 35313101. PMCID: PMC9016306.

2. Ouchi Y, Rakugi H, Arai H, et al. 2017; Redefining the elderly as aged 75 years and older: proposal from the Joint Committee of Japan Gerontological Society and the Japan Geriatrics Society. Geriatr Gerontol Int. 17:1045–1047. DOI: 10.1111/ggi.13118. PMID: 28670849.

3. Wildiers H, Heeren P, Puts M, et al. 2014; International Society of Geriatric Oncology consensus on geriatric assessment in older patients with cancer. J Clin Oncol. 32:2595–2603. DOI: 10.1200/JCO.2013.54.8347. PMID: 25071125. PMCID: PMC4876338.

4. Tsukuma H, Oshima A, Narahara H, Morii T. 2000; Natural history of early gastric cancer: a non-concurrent, long term, follow up study. Gut. 47:618–621. DOI: 10.1136/gut.47.5.618. PMID: 11034575. PMCID: PMC1728114.

5. Oh SY, Lee JH, Lee HJ, et al. 2019; Natural history of gastric cancer: observational study of gastric cancer patients not treated during follow-up. Ann Surg Oncol. 26:2905–2911. DOI: 10.1245/s10434-019-07455-z. PMID: 31190210.

6. Zhao J, Sun Z, Liang J, Guo S, Huang D. 2022; Endoscopic submucosal dissection for early gastric cancer in elderly vs. non-elderly patients: a systematic review and meta-analysis. Front Oncol. 11:718684. DOI: 10.3389/fonc.2021.718684. PMID: 35096560. PMCID: PMC8792970.

7. Ding X, Luo H, Duan H. 2019; Risk factors for perforation of gastric endoscopic submucosal dissection: a systematic review and metaanalysis. Eur J Gastroenterol Hepatol. 31:1481–1488. DOI: 10.1097/MEG.0000000000001543. PMID: 31688250.

8. Sugimoto M, Hatta W, Tsuji Y, et al. 2021; Risk factors for bleeding after endoscopic submucosal dissection for gastric cancer in elderly patients older than 80 years in Japan. Clin Transl Gastroenterol. 12:e00404. DOI: 10.14309/ctg.0000000000000404. PMID: 34644281. PMCID: PMC8659993.

9. Japanese Gastric Cancer Association. 2021; Japanese gastric cancer treatment guidelines 2018 (5th edition). Gastric Cancer. 24:1–21. DOI: 10.1007/s10120-020-01042-y. PMID: 32060757. PMCID: PMC7790804.

10. Guideline Committee of the Korean Gastric Cancer Association (KGCA), Development Working Group & Review Panel. Korean practice guideline for gastric cancer 2018: an evidence-based, multi-disciplinary approach. J Gastric Cancer. 2019; 19:1–48. DOI: 10.5230/jgc.2019.19.e8. PMID: 30944757. PMCID: PMC6441770.

11. Jung DH, Lee YC, Kim JH, et al. 2017; Additive treatment improves survival in elderly patients after non-curative endoscopic resection for early gastric cancer. Surg Endosc. 31:1376–1382. DOI: 10.1007/s00464-016-5123-3. PMID: 27450206.

12. Kusano C, Iwasaki M, Kaltenbach T, Conlin A, Oda I, Gotoda T. 2011; Should elderly patients undergo additional surgery after non-curative endoscopic resection for early gastric cancer? Long-term comparative outcomes. Am J Gastroenterol. 106:1064–1069. DOI: 10.1038/ajg.2011.49. PMID: 21407189.

13. Hatta W, Gotoda T, Koike T, Masamune A. 2020; Management following endoscopic resection in elderly patients with early-stage upper gastrointestinal neoplasia. Dig Endosc. 32:861–873. DOI: 10.1111/den.13592. PMID: 31802529.

14. Kim SG, Park CM, Lee NR, et al. 2018; Long-term clinical outcomes of endoscopic submucosal dissection in patients with early gastric cancer: a prospective multicenter cohort study. Gut Liver. 12:402–410. DOI: 10.5009/gnl17414. PMID: 29588436. PMCID: PMC6027839.

15. Hatta W, Gotoda T, Oyama T, et al. 2017; Is radical surgery necessary in all patients who do not meet the curative criteria for endoscopic submucosal dissection in early gastric cancer? A multi-center retrospective study in Japan. J Gastroenterol. 52:175–184. DOI: 10.1007/s00535-016-1210-4. PMID: 27098174.

16. Suzuki H, Takizawa K, Hirasawa T, et al. 2019; Short-term outcomes of multicenter prospective cohort study of gastric endoscopic resection: 'real-world evidencé in Japan. Dig Endosc. 31:30–39. DOI: 10.1111/den.13246. PMID: 30058258.

17. Esaki M, Hatta W, Shimosegawa T, et al. 2019; Age affects clinical management after noncurative endoscopic submucosal dissection for early gastric cancer. Dig Dis. 37:423–433. DOI: 10.1159/000499538. PMID: 31096243.

18. Ito H, Inoue H, Ikeda H, et al. 2013; Surgical outcomes and clinicopathological characteristics of patients who underwent potentially noncurative endoscopic resection for gastric cancer: a report of a single-center experience. Gastroenterol Res Pract. 2013:427405. DOI: 10.1155/2013/427405. PMID: 23762035. PMCID: PMC3670513.

19. Kawata N, Kakushima N, Takizawa K, et al. 2017; Risk factors for lymph node metastasis and long-term outcomes of patients with early gastric cancer after non-curative endoscopic submucosal dissection. Surg Endosc. 31:1607–1616. DOI: 10.1007/s00464-016-5148-7. PMID: 27495338.

20. Suzuki H, Oda I, Abe S, et al. 2017; Clinical outcomes of early gastric cancer patients after noncurative endoscopic submucosal dissection in a large consecutive patient series. Gastric Cancer. 20:679–689. DOI: 10.1007/s10120-016-0651-z. PMID: 27722825.

21. Jung DH, Huh CW, Kim JH, et al. 2017; Risk-stratification model based on lymph node metastasis after noncurative endoscopic resection for early gastric cancer. Ann Surg Oncol. 24:1643–1649. DOI: 10.1245/s10434-017-5791-9. PMID: 28150166.

22. Kim HS, Ahn JY, Kim SO, Kim BS. 2017; Can further gastrectomy be avoided in patients with incomplete endoscopic resection? Surg Endosc. 31:4735–4748. DOI: 10.1007/s00464-017-5550-9. PMID: 28424913.

23. Hatta W, Gotoda T, Oyama T, et al. 2017; A scoring system to stratify curability after endoscopic submucosal dissection for early gastric cancer: "eCura system". Am J Gastroenterol. 112:874–881. DOI: 10.1038/ajg.2017.95. PMID: 28397873.

24. Palumbo A, Bringhen S, Mateos MV, et al. 2015; Geriatric assessment predicts survival and toxicities in elderly myeloma patients: an International Myeloma Working Group report. Blood. 125:2068–2074. DOI: 10.1182/blood-2014-12-615187. PMID: 25628469. PMCID: PMC4375104.

25. Kroep JR, van Werkhoven E, Polee M, et al. 2015; Randomised study of tegafur-uracil plus leucovorin versus capecitabine as first-line therapy in elderly patients with advanced colorectal cancer--TLC study. J Geriatr Oncol. 6:307–315. DOI: 10.1016/j.jgo.2015.05.004. PMID: 26073532.

26. Goede V, Bahlo J, Chataline V, et al. 2016; Evaluation of geriatric assessment in patients with chronic lymphocytic leukemia: results of the CLL9 trial of the German CLL study group. Leuk Lymphoma. 57:789–796. DOI: 10.3109/10428194.2015.1091933. PMID: 26377031.

27. Corre R, Greillier L, Le Caër H, et al. 2016; Use of a Comprehensive geriatric assessment for the management of elderly patients with advanced non-small-cell lung cancer: the phase III randomized ESOGIA-GFPC-GECP 08-02 study. J Clin Oncol. 34:1476–1483. DOI: 10.1200/JCO.2015.63.5839. PMID: 26884557.

28. Tanoue K, Fukunaga S, Nagami Y, et al. 2019; Long-term outcome of endoscopic submucosal dissection for early gastric cancer in patients with severe comorbidities: a comparative propensity score analysis. Gastric Cancer. 22:558–566. DOI: 10.1007/s10120-018-0889-8. PMID: 30382467.

29. Iwai N, Dohi O, Naito Y, et al. 2018; Impact of the Charlson comorbidity index and prognostic nutritional index on prognosis in patients with early gastric cancer after endoscopic submucosal dissection. Dig Endosc. 30:616–623. DOI: 10.1111/den.13051. PMID: 29532961.

30. Sekiguchi M, Oda I, Suzuki H, et al. 2017; Clinical outcomes and prognostic factors in gastric cancer patients aged ≥85 years undergoing endoscopic submucosal dissection. Gastrointest Endosc. 85:963–972. DOI: 10.1016/j.gie.2016.10.013. PMID: 27751873.

31. Chang JW, Jung DH, Park JC, Shin SK, Lee SK, Lee YC. 2020; Long-term outcomes and prognostic factors of endoscopic submucosal dissection for early gastric cancer in patients aged ≥75 years. Cancers (Basel). 12:3222. DOI: 10.3390/cancers12113222. PMID: 33142928. PMCID: PMC7692251.