Endoscopy 2020; 52(S 01): S225-S226
DOI: 10.1055/s-0040-1704704
ESGE Days 2020 ePoster Podium presentations
Saturday, April 25, 2020 14:30 – 15:00 Upper GI: Endoscopic cancer treatment 1 ePoster Podium 1
© Georg Thieme Verlag KG Stuttgart · New York

PROGNOSTIC INFLUENCE OF ADDITIONAL SURGERY FOR GASTRIC CANCERS WITH SUBMUCOSAL INVASION CLASSIFIED INTO NON-CURATIVE RESECTION AFTER ENDOSCOPIC SUBMUCOSAL DISSECTION IN ELDERLY PATIENTS

Y Takagi
1   Japan Community Healthcare Organization Osaka Hospital, Department of Gastroenterology, Osaka city, Japan
,
K Yamamoto
1   Japan Community Healthcare Organization Osaka Hospital, Department of Gastroenterology, Osaka city, Japan
,
T Michida
2   Saitama Medical Center, Saitama University, Department of Gastroenterology and Hepatology, Saitama, Japan
,
Y Tokuda
1   Japan Community Healthcare Organization Osaka Hospital, Department of Gastroenterology, Osaka city, Japan
,
S Hiyama
1   Japan Community Healthcare Organization Osaka Hospital, Department of Gastroenterology, Osaka city, Japan
,
N Tatsumi
1   Japan Community Healthcare Organization Osaka Hospital, Department of Gastroenterology, Osaka city, Japan
,
T Ito
1   Japan Community Healthcare Organization Osaka Hospital, Department of Gastroenterology, Osaka city, Japan
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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    Aims In Japanese gastric cancer treatment guideline (2018), after endoscopic submucosal dissection (ESD), gastric cancer with submucosal invasion which histological findings reveal SM2 (≧500 µm), lymphatic invasion, venous invasion, positive vertical margin, ulcerative finding, larger tumor size (≧3 cm), or undifferentiated type is classified into non-curative resection, eCuraC2. In eCuraC2, additional surgery with lymph node dissection is recommended, but additional surgery may be excessive, especially for elderly patients with comorbidities.

    Methods One hundred eighteen lesions of 117 patients are classified into eCuraC2 with SM invasion at our hospital from April 2006 to March 2019. Those patients were divided into non-elderly group (< 75 years old) and elderly group (≧75 years old). We retrospectively analyzed overall survival (OS), disease-free survival (DFS), and disease-specific survival (DSS) for radical surgery patients and no additional treatment patients in individual age groups.

    Results Non-elderly group and elderly group were 76 and 41, respectively. OS, DFS, and DSS

    (5 years) in all patients were 86.0%, 93.1%, and 97.7%, respectively. Regarding OS, radical surgery patients (n = 57) and no additional treatment patients (n = 19) in non-elderly group were 92.2% and 91.2%, respectively, and radical surgery patients (n = 23) and no additional treatment patients (n = 18) in elderly group were 74.2% and 79.6%, respectively. In radical surgery patients, non-elderly group had significantly better OS than elderly group (p = 0.03), but in no additional treatment patients there was no significant difference between two age groups. Also, death from causes not related to gastric cancer occurred in 6.6% (5/76) of the patients in non-elderly group, in contrast to 17.1% (4/41) in elderly group (p = 0.08).

    Conclusions In eCuraC2 of elderly patients, there was less gastric-cancer-related death, and other diseases were prognostically important in those patients. In eCuraC2 of elderly patients, no additional treatment is also considered depending on their comorbidities.


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