Long-term outcomes of endoscopic resection of superficial esophageal squamous cell carcinoma in late-elderly patients.

IF 3.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Katsunori Matsueda, Seiji Kawano, Keisuke Fukui, Shoichiro Hirata, Takuya Satomi, Shoko Inoo, Kenta Hamada, Yoshiyasu Kono, Masaya Iwamuro, Yoshiro Kawahara, Motoyuki Otsuka
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引用次数: 0

Abstract

Background and aim: As the population ages, the number of elderly patients with superficial esophageal squamous cell carcinoma (ESCC) is increasing. We aimed to clarify the indications for endoscopic resection (ER) in late-elderly patients with ESCC in terms of life expectancy.

Methods: Patients aged ≥75 years who underwent ER for ESCC at our institution from January 2005 to December 2018 were enrolled. Clinical data, including the Eastern Cooperative Oncology Group performance status, American Society of Anesthesiologists physical status (ASA-PS), Charlson comorbidity index, and prognostic nutritional index (PNI), were collected at the time of ER. The main outcome measure was overall survival (OS).

Results: Two hundred eight consecutive patients were enrolled. The patients' median age was 78 years (range, 75-89 years). The 5-year follow-up rate was 88.5% (median follow-up period, 6.6 years). The 5-year OS rate was 79.2% (95% confidence interval [CI], 72.2-84.8), and 5-year net survival standardized for age, sex, and calendar year was 1.04 (95% CI, 0.98-1.09). In the multivariate analysis, an ASA-PS of 3 (hazard ratio, 2.45; 95% CI, 1.16-5.17) and PNI of <44.0 (hazard ratio, 2.73; 95% CI, 1.38-5.40) were independent prognostic factors. When neither of these factors was met, the 5-year OS rate was 87.8% (95% CI, 80.0-92.9), and 5-year net survival was 1.08 (95% CI, 1.02-1.14).

Conclusions: ER for ESCC in late-elderly patients may improve life expectancy. ER is recommended in patients with a good ASA-PS and PNI.

晚期老年食管浅表鳞状细胞癌内镜切除术的长期疗效。
背景和目的:随着人口老龄化,患有浅表食管鳞状细胞癌(ESCC)的老年患者越来越多。我们旨在从预期寿命的角度明确晚期老年食管鳞癌患者内镜下切除术(ER)的适应症:纳入2005年1月至2018年12月在我院接受ESCC内镜切除术的年龄≥75岁的患者。收集急诊室时的临床数据,包括东部合作肿瘤学组表现状态、美国麻醉医师协会体能状态(ASA-PS)、Charlson合并症指数和预后营养指数(PNI)。主要结果指标为总生存率(OS):结果:共有 28 名患者连续入组。患者的中位年龄为 78 岁(75-89 岁)。5年随访率为88.5%(中位随访时间为6.6年)。5年OS率为79.2%(95%置信区间[CI],72.2-84.8),按年龄、性别和日历年标准化的5年净生存率为1.04(95% CI,0.98-1.09)。在多变量分析中,ASA-PS 为 3(危险比为 2.45;95% CI 为 1.16-5.17)和 PNI 为 3(危险比为 2.45;95% CI 为 1.16-5.17):对晚期老年 ESCC 患者进行 ER 治疗可改善预期寿命。建议ASA-PS和PNI良好的患者进行ER治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.90
自引率
2.40%
发文量
326
审稿时长
2.3 months
期刊介绍: Journal of Gastroenterology and Hepatology is produced 12 times per year and publishes peer-reviewed original papers, reviews and editorials concerned with clinical practice and research in the fields of hepatology, gastroenterology and endoscopy. Papers cover the medical, radiological, pathological, biochemical, physiological and historical aspects of the subject areas. All submitted papers are reviewed by at least two referees expert in the field of the submitted paper.
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