Endoscopic submucosal dissection for colorectal precancerous lesions and early cancer in the elderly over 80 years old
10.3760/cma.j.cn321463-20201207-00616
- VernacularTitle:内镜黏膜下剥离术治疗超高龄患者结直肠癌前病变及早期癌的临床疗效分析
- Author:
Enpan XU
1
;
Bing LI
;
Pinghong ZHOU
;
Liqing YAO
;
Qiang SHI
;
Shilun CAI
;
Zhipeng QI
;
Di SUN
;
Yunshi ZHONG
Author Information
1. 复旦大学附属中山医院内镜中心 上海消化内镜诊疗工程技术研究中心，上海 200032
- Keywords:
Colorectal neoplasms;
Age groups;
Safety;
Endoscopic submucosal dissection
- From:
Chinese Journal of Digestive Endoscopy
2021;38(12):985-990
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the safety, efficacy and long-term survival of endoscopic submucosal dissection (ESD) for colorectal precancerous lesions and early cancer in the elderly over 80 years old.Methods:Clinical data of colorectal precancerous lesions and early cancer treated with ESD from January 2007 to December 2014 at Endoscopy Center of Zhongshan Hospital, Fudan University were retrospectively analyzed. A total of 721 patients with 778 lesions were included in this study. These patients were stratified by age: the super-elderly group (≥80 years old, 55 patients, 7.6%) and the non-super-elderly group (<80 years old, 666 patients, 92.4%). The outcomes of ESD, complication incidences, pathological characteristics, and long-term survival were compared between the two groups.Results:Except that the incidence of chronic concomitant diseases in the super-elderly group was significantly higher than that in the non-super-elderly group [54.5% (30/55) VS 31.5% (210/666), P<0.001], other baseline characteristics were not significantly different ( P>0.05). There were no significant differences in the complete resection rate [93.1%(54/58) VS 95.3%(686/720)], the R0 resection rate [89.7% (52/58) VS 93.2% (671/720)], the curative resection rate [84.5% (49/58) VS 90.3% (650/720)], the complication incidence [5.5% (3/55) VS 2.7%(18/666)], or the median hospitalization (2.98 days VS 2.54 days) between the two groups (all P>0.05). The three-year overall survival rates of the super-elderly group and non-super-elderly group were 95.8% and 98.0%, respectively, and the five-year overall survival rates were 85.1% and 97.4%, respectively. Conclusion:Colorectal ESD is safe and effective for elderly patients (age ≥80 years old) despite a significantly higher incidence of chronic concomitant diseases than that in the non-super-elderly patients.
