老年食管胃双原发癌同期内镜黏膜下剥离术的疗效

doi:10.3969/j.issn.1003-9198.2025.11.014

Abstract

Abstract: Objective To assess the clinical efficacy of endoscopic submucosal dissection (ESD) for double primary cancers of the esophagus and stomach in the elderly patients. Methods The clinicopathological data of 115 elderly patients with both superficial esophageal cancer (SEC) and early gastric cancer (EGC) were retrospectively analyzed to evaluate the short- and long-term efficacy of simultaneous resection by ESD. The patients were divided into curative resection group and non-curative resection group according to whether both esophageal and gastric lesions achieved curative resection by ESD, and the prognosis of the two groups was compared. Results The en bloc resection rate, complete resection rate and curative resection rate of the double lesions in 115 elderly patients was 100% (115/115), 93.9% (108/115) and 72.2% (83/115), respectively. Complications were observed in 11 patients (9.6%), including 7 cases of bleeding and 4 cases of esophageal stenosis. During a median follow-up time of 53 months, distant metastases occurred in 3 (2.6%) patients, and simultaneous and metachronous cancers developed in 5 (4.3%) and 15 (13.0%) patients, respectively, and there were no patients with local recurrence. The overall survival rate was 87.8% (101/115), and the disease-specific survival rate was 97.4%(112/115). The incidence of metachronous cancers (7.2% vs 28.1%) and distant metastasis (0 vs 9.4%) was lower, and the overall survival rate (92.8% vs 75.0%) and disease-specific survival rate (100% vs 93.7%) were both significantly higher in the curative resection group than those in the non-curative resection group (P＜0.05). Conclusions ESD may be a safe and effective treatment method for elderly patients with double primary cancers of the esophagus and stomach. The patients with curative resection of esophagogastric lesions have a better prognosis, but long-term postoperative endoscopic surveillance is needed.

Key words: endoscopic submucosal dissection, superficial esophageal cancer, early gastric cancer, aged, efficacy

CLC Number:

WU Hai, MAO Shangtao, XIANG Ying, MA Yichun, PAN Yinya, LI Wenjun, XU Guifang. Efficacy of simultaneous endoscopic submucosal dissection for double primary cancers of the esophagus and stomach in elderly[J]. Practical Geriatrics, 2025, 39(11): 1140-1144.

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Efficacy of simultaneous endoscopic submucosal dissection for double primary cancers of the esophagus and stomach in elderly

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