Clinical Outcomes and Prognostic Factors in Older Adult Patients Aged ≥75 Years With Early Gastric Cancer After Endoscopic Resections: A Nationwide Cohort Study

PURPOSE: With the aging population, the number of older adult patients undergoing endoscopic resections (ERs) for early gastric cancer (EGC) has increased. However, data on the long-term outcomes in these patients remain limited. We evaluated long- and short-term outcomes and identified factors associated with outcomes in older adult patients with EGC after ERs. MATERIALS AND METHODS: Data from older patients (aged ≥75 years) who underwent ERs for EGC between 2011 and 2019 were collected from the Korean National Health Insurance database. Baseline characteristics, clinical outcomes, and outcome-associated risk factors were investigated. RESULTS: In total, 7,331 patients (mean age: 79.0 years) were included. During the 74.7-month median follow-up, 2,436 (33.2%) patients died, of whom 291 (4.0%) died of gastric cancer. The 3-, 5-, and 10-year overall survival rates were 91.3%, 82.1%, and 53.3%, respectively. The 3-, 5-, and 10-year cancer-specific survival rates were 98.3%, 96.9%, and 94.0%, respectively. Within 90 days after ER, 1,900 (25.9%) patients were readmitted, and 32 (0.4%) died. Risk factors associated with all-cause mortality were age ≥80 years, lower baseline hemoglobin level, higher baseline creatinine level, being underweight, current smoking, and a medical history of myocardial infarction, congestive heart failure, dementia, or renal disease. A body mass index ≥25 kg/m² was associated with lower overall mortality. CONCLUSIONS: When deciding on ER for EGC in late-older adult patients (aged ≥75 years), incorporating risk factors may be useful for risk stratification and prognostic counseling.