Background: The Japanese population is rapidly aging, and the actual number of elderly patients with gastric cancer, including early cancer, has been increasing, even though the standardized incidence of gastric cancer in the population is decreasing. The optimal treatment for these patients remains a challenge to th e surgeon. The aim of this retrospective analysis was to describe the results of gastrectomy and EMR for early gastric cancer in elderly patients (80 years of a ge and over). Methods: This is a retrospective review of 93 elderly patients who had undergone gastrectomy or EMR at the National Cancer Center Hospital for ear ly gastric cancer. EMR was performed aiming en bloc local resection with a clear curative margin (R0). The clinicopathologic characteristics, comorbidity, posto perative mortality, and outcome were recorded. Results: Gastrectomy was performe d in 44 patients (surgery group) and EMR in 49 patients (EMR group). There were significant differences in mean tumor size (p < 0.05), histologic type (p < 0.05 ), and depth of tumor invasion (p < 0.05) between the two groups. There was no s ignificant difference in comorbidity between the two groups. No operative death was reported in either group. In the EMR group, 7 patients were reported to have recurrence of local disease and two patients died of advanced disease. There we re no significant differences in the overall 3-year survival rate or the 5-yea r survival rate between the surgery group and EMR group (73.5%vs. 82.5%and 55. 0%vs. 62.5%, respectively). Conclusions: EMR (R0) resection was performed safe ly in the elderly, and the overall results were excellent, the same as the resul ts with gastrectomy. Gastrectomy can still be performed if EMR is unsuccessful.
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