Scoring system for predicting the prognosis of elderly gastric cancer patients after endoscopic submucosal dissection

被引：3

作者：

Ito, Nobuhito ^{[1
,2
]}

Funasaka, Kohei ^{[4
]}

Fujiyoshi, Toshihisa ^{[5
]}

Nishida, Kazuki ^{[3
]}

Furukawa, Kazuhiro ^{[1
,2
]}

Kakushima, Naomi ^{[1
,2
,6
]}

Furune, Satoshi ^{[1
,2
]}

Ohno, Eizaburo ^{[1
,2
]}

Nakamura, Masanao ^{[1
,2
]}

Horiguchi, Noriyuki ^{[4
]}

Shibata, Tomoyuki ^{[4
]}

Miyahara, Ryoji ^{[4
]}

Haruta, Jun-Ichi ^{[5
]}

Hirooka, Yoshiki ^{[4
]}

Fujishiro, Mitsuhiro ^{[1
,2
,6
]}

Kawashima, Hiroki ^{[1
,2
]}

机构：

[1] Nagoya Univ, Dept Gastroenterol, Grad Sch Med, Nagoya, Aichi, Japan

[2] Nagoya Univ, Dept Hepatol, Grad Sch Med, Nagoya, Aichi, Japan

[3] Nagoya Univ, Ctr Adv Med & Clin Res, Biostat Sect, Grad Sch Med, Nagoya, Aichi, Japan

[4] Fujita Hlth Univ, Dept Gastroenterol & Hepatol, Sch Med, 1-98 Kutsukake Cho, Toyoake, Aichi 4701192, Japan

[5] Nagoya Daiichi Hosp, Japanese Red Cross Aichi Med Ctr, Nagoya, Aichi, Japan

[6] Univ Tokyo, Grad Sch Med, Dept Gastroenterol, Tokyo, Japan

来源：

DIGESTIVE ENDOSCOPY | 2023年 / 35卷 / 01期

关键词：

aged; endoscopy; prognosis; retrospective study; stomach neoplasm; CLINICAL-OUTCOMES; LONG-TERM; SKELETAL-MUSCLE; RESECTION; NEOPLASMS; SURVIVAL; CRITERIA; MASS;

D O I：

10.1111/den.14416

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Objectives Comprehensive assessments of the long-term outcomes of endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) in the elderly are unavailable. We aimed to create a scoring system to predict the long-term prognosis after ESD for EGC among patients aged >= 75 years. Methods We conducted retrospective studies of two cohorts: a single-center cohort (2006-2011) for developing the scoring system, and a multicenter cohort for validating the developed system (2012-2016). In the development cohort, factors related to death after ESD were identified using multivariable Cox regression analysis, and a predictive scoring system was developed. In the validation cohort, the scoring system was validated in 295 patients. Results In the development cohort, Charlson comorbidity index (CCI) >= 3 (hazard ratio [HR] 3.017), high psoas muscle index (PMI) (HR 2.206), and age >= 80 years (HR 1.978) were significantly related to overall survival after ESD. Therefore, high CCI, low PMI, and age >= 80 years were assigned 1 point each. The patients were categorized into low (<= 1 point) and high (>= 2 points) score groups based on their total scores. In the validation cohort, 184 and 111 patients were assigned to the low- and high-score groups, respectively. In comparisons based on Kaplan-Meier curves, the 5-year survival rate was 91.5% in the low-score group and 57.8% in the high-score group (log-rank test; P < 0.001). Conclusion Our scoring system including high CCI, low PMI, and age >= 80 years could stratify the long-term prognosis of elderly patients aged >= 75 years after ESD for EGC.

引用

页码：67 / 76

页数：10

共 37 条

[1] Multicenter study of the long-term outcomes of endoscopic submucosal dissection for early gastric cancer in patients 80 years of age or older [J].