Clinical outcomes and prognostic factors for survival after endoscopic submucosal dissection (ESD) in older patients aged ≥ 85 years with early gastric cancer (EGC) are not well defined. The aim of this study was to investigate the clinical outcomes and prognostic factors for survival after ESD in older patients aged ≥ 85 years with EGC. Clinical outcomes of 70 patients aged ≥ 85 years with EGC treated with ESD were evaluated retrospectively. Prognostic factors for overall survival (OS) were analyzed with the Kaplan–Meier method and a Cox proportional hazards model. During the follow-up period, 33 patients died from any cause, none of whom died from gastric cancer. OS probability after 3 years was 90.0%. Univariate analyses revealed that a neutrophil/lymphocyte ratio ≥ 2.6, a prognostic nutritional index (PNI) < 42.5 and low serum albumin value (< 3.5 g/dl) were associated with poor OS. Cox multivariate analysis revealed low PNI (< 42.5) to be an independent prognostic factor associated with OS (hazard ratio; 3.40, 95% confidence interval; 1.47–7.86, P = 0.004). PNI may be a useful parameter for making the decision to perform ESD for older patients aged ≥ 85 years with EGC.

中文翻译：

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预后营养指数是胃内镜黏膜下剥离术治疗≥85岁老年患者的独立预后因素

对于 85 岁以上的早期胃癌 (EGC) 老年患者，内镜黏膜下剥离术 (ESD) 后生存的临床结果和预后因素尚未明确。本研究的目的是调查 85 岁以上 EGC 老年患者 ESD 后生存的临床结果和预后因素。回顾性评估了 70 名年龄≥85 岁的 EGC 患者接受 ESD 治疗的临床结果。使用 Kaplan-Meier 方法和 Cox 比例风险模型分析总生存期 (OS) 的预后因素。随访期间，33例患者因任何原因死亡，无一例死于胃癌。3 年后的 OS 概率为 90.0%。单变量分析显示，中性粒细胞/淋巴细胞比率≥ 2.6，预后营养指数 (PNI) < 42。5 和低血清白蛋白值 (< 3.5 g/dl) 与较差的 OS 相关。Cox 多变量分析显示低 PNI (< 42.5) 是与 OS 相关的独立预后因素（风险比；3.40，95% 置信区间；1.47-7.86，P = 0.004）。PNI 可能是决定对 85 岁以上的 EGC 老年患者进行 ESD 的有用参数。