{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T20:18:41Z","timestamp":1790194721857,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T00:00:00Z","timestamp":1776556800000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["DEN Open"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>With an aging society, the proportion of elderly patients undergoing gastric endoscopic submucosal dissection (ESD) is increasing. Although procedure\u2010related adverse events (AEs) are comparable between the elderly and non\u2010elderly patients, data on non\u2010procedure\u2010related AEs remain limited. This study aimed to evaluate the short\u2010 and long\u2010term outcomes of gastric ESD in elderly patients, focusing on risk factors for non\u2010procedure\u2010related AEs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 941 patients who underwent gastric ESD at two institutions between 2011 and 2024. Patients were stratified into elderly (\u226580 years) and non\u2010elderly (&lt;80 years) groups, and short\u2010 and long\u2010term outcomes were compared. Procedure\u2010related AEs included delayed bleeding, perforation, and stricture, whereas non\u2010procedure\u2010related AEs included pneumonia and other systemic complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Procedure\u2010related AE rates were similar between the groups (8.9%\u00a0vs. 7.1%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.322), whereas the overall (13.8%\u00a0vs. 8.3%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.010) and non\u2010procedure\u2010related AE rates (5.8%\u00a0vs. 1.4%,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) were significantly higher in elderly patients. Univariate analysis showed that Eastern Cooperative Oncology Group performance status (PS) \u2265 2 and Charlson Comorbidity Index (CCI) \u2265 2 were significant risk factors for non\u2010procedure\u2010related AEs among elderly patients. Non\u2010procedure\u2010related AEs were significantly associated with poorer overall survival (OS) (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.013). Multivariate analysis identified systemic factors, including age, albumin level, CCI, and PS, as independent prognostic factors for OS in elderly patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Assessment of systemic health status, particularly using PS and CCI, is essential for predicting non\u2010procedure\u2010related AEs, and they are useful indices for determining treatment indications in elderly patients undergoing gastric ESD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>\n                      <jats:bold>Trial Registration<\/jats:bold>\n                      : Not applicable.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/deo2.70334","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T04:33:54Z","timestamp":1776659634000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Short\u2010 and Long\u2010Term Outcomes of Endoscopic Submucosal Dissection for Gastric Lesions in Elderly Patients Aged 80 Years or Older: Focus on Non\u2010Procedure\u2010Related Adverse Events"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0850-505X","authenticated-orcid":false,"given":"Hideharu","family":"Ogiyama","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Ikeda Municipal Hospital  Ikeda Japan"},{"name":"Department of Gastroenterology and Hepatology Itami City Hospital  Itami 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