BACKGROUND: Gastric cancer can present with the endoscopic appearances of a benign gastric ulcer (GU). Opinion remains divided on the need for follow-up of patients diagnosed with GU, and the aim of this study was to examine the long-term outcomes of patients whose GU proved malignant on follow-up gastroscopy. METHODS: Between October 1, 1995, and September 30, 2003, 25,579 gastroscopies were performed in one unit. These identified 544 patients with apparently benign GU, of whom 277 (51%) underwent 334 elective follow-up endoscopies. Twelve of these patients (4.3%) were shown to have a malignant ulcer; their outcomes were compared to those of the 296 other patients diagnosed with gastric cancers in this time frame. RESULTS: The patients in the GU cancer group had earlier stage disease (stage I, 33% vs 6.4%; chi2 = 11.2; DF1; P = 0.001), and were more likely to undergo R0 gastrectomy (50% vs 30%; chi2 = 2.064; DF1; P = 0.151) and to survive long term (46% vs 16%; log-rank chi2, 5.79; DF1; P = 0.0162) than patients in the comparison cohort. CONCLUSION: Gastroscopic follow-up of 50 patients with an apparently benign GU will identify 1 patient with a malignancy destined to survive for 5 years following R0 gastrectomy. This justifies the diagnostic effort of repeat gastroscopy to ensure complete healing of GU.
BACKGROUND:Gastric cancer can present with the endoscopic appearances of a benign gastric ulcer (GU). Opinion remains divided on the need for follow-up of patients diagnosed with GU, and the aim of this study was to examine the long-term outcomes of patients whose GU proved malignant on follow-up gastroscopy. METHODS: Between October 1, 1995, and September 30, 2003, 25,579 gastroscopies were performed in one unit. These identified 544 patients with apparently benign GU, of whom 277 (51%) underwent 334 elective follow-up endoscopies. Twelve of these patients (4.3%) were shown to have a malignant ulcer; their outcomes were compared to those of the 296 other patients diagnosed with gastric cancers in this time frame. RESULTS: The patients in the GU cancer group had earlier stage disease (stage I, 33% vs 6.4%; chi2 = 11.2; DF1; P = 0.001), and were more likely to undergo R0 gastrectomy (50% vs 30%; chi2 = 2.064; DF1; P = 0.151) and to survive long term (46% vs 16%; log-rank chi2, 5.79; DF1; P = 0.0162) than patients in the comparison cohort. CONCLUSION: Gastroscopic follow-up of 50 patients with an apparently benign GU will identify 1 patient with a malignancy destined to survive for 5 years following R0 gastrectomy. This justifies the diagnostic effort of repeat gastroscopy to ensure complete healing of GU.
Authors: Jonathan D Barry; Guy R J C Blackshaw; Paul Edwards; Wyn G Lewis; Paula Murphy; Ilias Hodzovic; Ian W Thompson; Miles C Allison Journal: Gastric Cancer Date: 2003 Impact factor: 7.370
Authors: Guy R Blackshaw; Jonathan D Barry; Paul Edwards; Miles C Allison; Wyn G Lewis Journal: Eur J Gastroenterol Hepatol Date: 2003-12 Impact factor: 2.566
Authors: R Peto; M C Pike; P Armitage; N E Breslow; D R Cox; S V Howard; N Mantel; K McPherson; J Peto; P G Smith Journal: Br J Cancer Date: 1976-12 Impact factor: 7.640
Authors: R Peto; M C Pike; P Armitage; N E Breslow; D R Cox; S V Howard; N Mantel; K McPherson; J Peto; P G Smith Journal: Br J Cancer Date: 1977-01 Impact factor: 7.640
Authors: William M Brindle; Rebecca K Grant; Marianne Smith; Meghan Suddaby; Angus Wallace; Sarah-Louise Gillespie; Nicholas I Church; Colin L Noble; Ian D Penman; John N Plevris; Alexander R Robertson; Eleanor F Watson; Christian P Selinger; Rahul Kalla; Gail S M Masterton Journal: Frontline Gastroenterol Date: 2021-02-26
Authors: Sabina Beg; Krish Ragunath; Andrew Wyman; Matthew Banks; Nigel Trudgill; D Mark Pritchard; Stuart Riley; John Anderson; Helen Griffiths; Pradeep Bhandari; Phillip Kaye; Andrew Veitch Journal: Gut Date: 2017-08-18 Impact factor: 23.059