Evidence map›Paper›PMID 41203902›Full record

ArticleSurgical endoscopy2026

Factors associated with adverse events and three-year survival following endoscopic submucosal dissection for early gastric cancer in patients aged 85 years or older.

Takaaki Yoshikawa, Takahiro Utsumi, Takahiro Inoue, Nobukazu Agatsuma, Yukari Tanaka, Yohei Yabuuchi, Osamu Araki, Katsuyuki Murai, Tomomasa Tochio, Ken Kumagai and 19 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Endoscopic Papillectomy for Ampullary Tumors in Older Patients: Balancing Oncologic Benefit and Geriatric Risk.Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2026
    Review
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

29 authors.

Takaaki YoshikawaDepartment of Gastroenterology and Hepatology, Medical Research Institute Kitano Hospital, PIIF Tazuke Kofukai, 2-4-20, Ohgimachi, Kita-Ku, Osaka, 530-8480, Japan. anctan180@gmail.com.ORCID 0000-0002-3173-4360
Takahiro UtsumiDepartment of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan.
Takahiro InoueDepartment of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan.
Nobukazu AgatsumaDepartment of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan.
Yukari TanakaDepartment of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan.
Yohei YabuuchiDepartment of Gastroenterology, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi, Chuo-Ku, Kobe, Hyogo, 650-0047, Japan.
Osamu ArakiDepartment of Gastroenterology and Hepatology, Kyoto Katsura Hospital, 17 Yamadahirao-Cho, Nishikyo-Ku, Kyoto, 612-8256, Japan.
Katsuyuki MuraiDepartment of Gastroenterology and Hepatology, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusa Mukaihata-Cho, Fushimi-Ku, Kyoto, 612-8555, Japan.
Tomomasa TochioDepartment of Gastroenterology and Hepatology, Tenri Hospital, 200 Mishima-Cho, Tenri, Nara, 632-8552, Japan.
Ken KumagaiDepartment of Gastroenterology and Hepatology, Kobe City Nishi-Kobe Medical Hospital, 7-5-1 Koji-Dai, Nishi-Ku, Kobe, 651-2273, Japan.
Hiroyoshi IwagamiDepartment of Gastroenterology and Hepatology, Japanese Red Cross Wakayama Medical Center, 4-20 Komatsubara-Dori, Wakayama, 640-8558, Japan.
Yuichi MasuiDepartment of Gastroenterology and Hepatology, Shizuoka General Hospital, 4-27-1 Kita Ando Aoi-Ku, Shizuoka, 420-8527, Japan.
Hirotaka KashimaDepartment of Gastroenterology and Hepatology, Shizuoka General Hospital, 4-27-1 Kita Ando Aoi-Ku, Shizuoka, 420-8527, Japan.
Takeshi SetoyamaDepartment of Gastroenterology and Hepatology, Osaka Red Cross Hospital, 5-30 Fudegasakicho, Tennoji-Ku, Osaka, 543-8555, Japan.
Takafumi KonishiDepartment of Gastroenterology and Hepatology, Japanese Red Cross Wakayama Medical Center, 4-20 Komatsubara-Dori, Wakayama, 640-8558, Japan.
Toshiyuki MorisawaDepartment of Gastroenterology and Hepatology, Osaka Saiseikai Nakatsu Hospital, 2-10-39, Shibata, Kita-Ku, Osaka, 530-0012, Japan.
Motoya KitamiDepartment of Gastroenterology and Hepatology, Japanese Red Cross Otsu Hospital, 1-1-35 Nagara, Otsu, Shiga, 520-0046, Japan.
Yasuyuki NishiokaDepartment of Gastroenterology and Hepatology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77, Higasinaniwa-Town, Amagasaki, Hyogo, 660-8550, Japan.
Naoki KandaDepartment of Gastroenterology and Hepatology, Takatsuki Red Cross Hospital, 1-1-1 Abuno, Takatsuki, Osaka, 569-1096, Japan.
Kenshi MatsuuraDepartment of Gastroenterology and Hepatology, Takamatsu Red Cross Hospital, 4-1-3 Bancho, Takamatsu, Kagawa, 760-0017, Japan.
Mikio FujiwaraDepartment of Gastroenterology and Hepatology, Kansai Electric Power Hospital, 2-1-7, Fukushima, Fukushima-Ku 54, Osaka, 553-0003, Japan.
Seiji ShioDepartment of Gastroenterology and Hepatology, Shinko Hospital, 1-4-47, Wakihama-Cho, Chuo-Ku, Kobe, Hyogo, 651-0072, Japan.
Junya TanakaDepartment of Gastroenterology and Hepatology, Mitsubishi Kyoto Hospital, 1 Katsura Gosho-Cho, Nishikyo-Ku, Kyoto, 615-8087, Japan.
Saiko MaruiDepartment of Gastroenterology and Hepatology, Shiga General Hospital, 5-4-30 Moriyama, Moriyama, Shiga, 524-0022, Japan.
Yoshitaka NishikawaDepartment of Health Informatics, Kyoto University School of Public Health, Yoshida-Konoe-Cho, Sakyo-Ku, Kyoto, 606-8501, Japan.
Yuki NakanishiDepartment of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan.
Shujiro YazumiDepartment of Gastroenterology and Hepatology, Medical Research Institute Kitano Hospital, PIIF Tazuke Kofukai, 2-4-20, Ohgimachi, Kita-Ku, Osaka, 530-8480, Japan.
Hiroshi SenoDepartment of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan.
KONOE Project

Funding

Japan Society for the Promotion of Science London JP22K21080Japan Society for the Promotion of Science London JP24K20216
6 · The paper itself

Abstract

backgroundEndoscopic submucosal dissection (ESD) is a safe and minimally invasive procedure for early gastric cancer (EGC). However, little is known about the adverse events and prognosis of gastric ESD in much older adult patients with age-related comorbidities. Therefore, we aimed to elucidate factors associated with the adverse events and prognosis of ESD for EGC in patients ≥ 85 years.

methodsWe enrolled 853 patients with 920 lesions ≥ 85 years old from 19 institutions who underwent ESD for EGC between January 2006 and December 2020. We adapted the Geriatric Nutritional Risk Index (GNRI) and analyzed the associations between GNRI and major adverse events post-ESD bleeding or perforation using logistic regression analysis. Subsequently, we performed the Cox proportional hazard model to elucidate whether age-related factors were associated with three-year overall survival.

resultsGNRI was significantly related with post-ESD bleeding [odds ratio (OR), 0.98; 95% confidence interval (CI), 0.96-1.00, p = 0.003]. Age (hazard ratio (HR); 95% CI 1.12 [1.02-1.22], p = 0.002), male (2.29 [1.24-3.34], p = 0.005), ECOG-Performance status (1.31 [1.16-1.75], p = 0.006), Charlson Comorbidity Index (1.17 [1.03-1.33], p = 0.002), and poor GNRI (0.92 [0.90-0.94], p < 0.001) were significantly correlated with three-year overall survival.

conclusionsNutritional status was associated with post-ESD bleeding. Nutritional status and comorbidities were related with prognosis after gastric ESD. Therefore, indications of gastric ESD in patients ≥ 85 years old need to be considered with age-related comorbidities.

Indexed as

Endoscopic Mucosal ResectionGastroscopyPostoperative ComplicationsPostoperative HemorrhageStomach NeoplasmsAged, 80 and overAge FactorsFemaleHumansMalePrognosisRetrospective StudiesRisk FactorsAdverse eventsEarly gastric cancerElderly patientsEndoscopic submucosal dissectionPrognosis

Identifiers

PMID41203902

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