Efficacy and safety of endoscopic submucosal dissection in elderly patients with esophageal squamous cell carcinoma.

Abstract

182 Background: Endoscopic submucosal dissection (ESD) has been widely applied to superficial esophageal squamous cell carcinoma (SCC) as a minimally invasive treatment, which has advantages over surgery especially in the elderly who are at high risk of surgery. This study elucidated the efficacy and safety of ESD for superficial esophageal SCC in the elderly. Methods: Between April 2007 and June 2016, a total of 176 patients with superficial esophageal SCC were studied. The short-term outcomes including En bloc resection, complete resection, and curative resection rate and procedure-related complication rates were compared between elderly group ( n = 20, ≥ 75 years of age) and non-elderly group ( n = 156, < 75 years of age). Results: The mean age of elderly group was 76.9 ± 1.5 years and that of non-elderly group was 62.9 ± 6.9 years ( p < 0.001). Sex, past medical history (hypertension and diabetes), body mass index, tumor characteristics (number, location, shape, maximal and circumferential size of tumor and resected specimen, and depth), and presence of stricture prevention did not differ between two groups. En bloc resection (95% vs 93.6%, p > 0.999), complete resection (85% vs 73.1%, p = 0.292), and curative resection rates (75% vs 56.4%, p = 0.149) did not differ significantly between two groups. Procedure time and hospital stay were also similar. Complications of ESD such as stricture (10% vs 12.8%, p > 0.999) and perforation (10% vs 7.7%, p = 0.587) occurred similarly. Conclusions: ESD for superficial esophageal SCC is effective and safe in elderly patients like in non-elderly patients.