TY - JOUR
T1 - Scoring system for predicting the prognosis of elderly gastric cancer patients after endoscopic submucosal dissection
AU - Ito, Nobuhito
AU - Funasaka, Kohei
AU - Fujiyoshi, Toshihisa
AU - Nishida, Kazuki
AU - Furukawa, Kazuhiro
AU - Kakushima, Naomi
AU - Furune, Satoshi
AU - Ohno, Eizaburo
AU - Nakamura, Masanao
AU - Horiguchi, Noriyuki
AU - Shibata, Tomoyuki
AU - Miyahara, Ryoji
AU - Haruta, Jun Ichi
AU - Hirooka, Yoshiki
AU - Fujishiro, Mitsuhiro
AU - Kawashima, Hiroki
N1 - Funding Information:
We thank all the doctors at the hospitals and clinics that cooperated in the prognostic study, as well as the members of the Department of Gastroenterology and Hepatology at Nagoya University.
Publisher Copyright:
© 2022 Japan Gastroenterological Endoscopy Society.
PY - 2023/1
Y1 - 2023/1
N2 - 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.
AB - 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.
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U2 - 10.1111/den.14416
DO - 10.1111/den.14416
M3 - Article
C2 - 36052429
AN - SCOPUS:85137246482
SN - 0915-5635
VL - 35
SP - 67
EP - 76
JO - Digestive Endoscopy
JF - Digestive Endoscopy
IS - 1
ER -