Comparison between endoscopic treatment and surgery for elderly population with early gastric cancer

Objective: Despite of the declining incidence of gastric cancer, the number of elder patients with gastric cancer is increasing because of aging society. The appropriate treatment strategies for elderly patients have not yet been well defined. The aim of this study is sought to evaluate short- and long-term outcomes after different therapies for early gastric cancers in elderly populations. Methods We identified elderly patients aged ≥ 60 years with early gastric cancer (T1 stage) from the Surveillance, Epidemiology and End Results (SEER) database during1998 to 2010. We compared clinic features between different treatment groups and evaluated 1-year, 3-year and 5-year cancer-specific survival outcomes. Results Totally 5639 elderly patients with early gastric cancer were identified from the SEER database (1998–2010). Among them, 2997 patients underwent surgical resection and 328 patients received endoscopic treatment (ET). In a Cox regression model, either surgery or endoscopic resection were associated with improved survival. The short- and long term survival for patients who underwent surgical or endoscopic resection were similar (one-year survival rate (SR) for surgery vs. ET, 89.3% vs. 89.9%, P > 0.05 ; five-year SR, 77.1% vs. 78.3%, P > 0.05 ). Conclusions In elderly patients with early gastric cancer, short- and long term survival outcomes were similar between ET and the surgical groups, which indicated that endoscopic therapy is an appropriate and alternative approach for early gastric cancers in older western populations.