[Should the elderly patients undergo additional surgery after non-curative endoscopic resection?].

BACKGROUND & AIMS: Endoscopic resection, including endoscopic mucosal dissection (ESD), has gained acceptance widely for early gastric cancer (EGC). However, after therapy, some elderly patients with non-curative resection do not undergo radical surgery, because elderly patients may have limited life expectancy or comorbid disease. The aim of this study is to verify if radical surgery after non-curative resection should be performed in the elderly patients as in young patients.

METHODS

This is a retrospective review of 432 elderly patients (over 75 years) who had undergone enodscopic resection for EGC at the National Cancer Center Hospital between January 1999 and December 2005. We compared the overall and disease-free survival rate between the curative resection group, non-curative resection with surgery group, and non-curative resection without surgery group.

RESULTS

A significant difference in overall and disease-free survival was evident between the patients with curative resection and non-curative resection without surgery.

CONCLUSIONS

In the patients with non-curative resection for ECG endoscopically, additional surgery is still necessary even in elderly patients.