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Prognostic factors and long-term outcomes with endoscopic submucosal dissection for colorectal tumors in patients aged 75 years or older

  • 0Department of Gastroenterology Jichi Medical University Saitama Medical Center Saitama Japan.
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May 7, 2025

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May 7, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Endoscopic submucosal dissection (ESD) in older patients with colorectal tumors shows that Charlson Comorbidity Index (CCI) and neutrophil-to-lymphocyte ratio (NLR) are key indicators for long-term survival. These factors aid in treatment decisions for elderly individuals undergoing colorectal ESD.

Area Of Science

  • Gastroenterology
  • Oncology
  • Geriatrics

Background

  • Limited data exists on long-term outcomes of endoscopic submucosal dissection (ESD) in elderly patients with colorectal tumors.
  • This study focuses on evaluating the long-term results and identifying prognostic factors for older individuals undergoing colorectal ESD.

Purpose Of The Study

  • To analyze the long-term outcomes of colorectal tumor patients aged 75 years and older who underwent ESD.
  • To identify independent prognostic factors influencing overall survival in this patient cohort.

Main Methods

  • Retrospective analysis of 156 patients aged ≥ 75 years who underwent ESD for colorectal tumors (adenoma and Tis/T1 cancer).
  • Kaplan-Meier method and Cox proportional hazard model were used to identify prognostic factors for overall survival.

Main Results

  • Of 156 patients, 51 died during follow-up; only two deaths were cancer-related.
  • Univariate analysis indicated age ≥83, Charlson Comorbidity Index (CCI) ≥2, prognostic nutritional index <46, and neutrophil-to-lymphocyte ratio (NLR) ≥3 were associated with poor survival.
  • Multivariate analysis identified CCI ≥2 (HR: 2.26) and NLR ≥3 (HR: 1.98) as independent prognostic factors for overall survival.

Conclusions

  • Charlson Comorbidity Index (CCI) and neutrophil-to-lymphocyte ratio (NLR) are significant independent prognostic factors in older patients undergoing colorectal ESD.
  • These parameters may assist in clinical decision-making for managing elderly patients requiring colorectal ESD.

Keywords:

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