Nerea Hernanz1, Enrique Rodríguez de Santiago2, Héctor Miguel Marcos Prieto3, Miguel Ángel Jorge Turrión4, Eva Barreiro Alonso5, Carlos Rodríguez Escaja4, Andrea Jiménez Jurado3, María Sierra1, Isabel Pérez Valle5, Nadja Volpato1, María García Prada3, Laura Nuñez-Gómez1, Raquel Ríos-León1, Andrés Castaño García3, Ana García García de Paredes1, Marta Aicart1, Alejandra Caminoa6, Beatriz Peñas Parcía7, Enrique Vázquez-Sequeiros7, Agustín Albillos8. 1. Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, University of Alcala, Spain. 2. Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, University of Alcala, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS),Spain. Electronic address: enrodesan@gmail.com. 3. Gastroenterology department, Hospital Universitario de Salamanca, University of Salamanca, IBSAL, Spain. 4. Department of Gastroenterology and Hepatology, Hospital Universitario Central de Asturias, Spain. 5. Gastroenterology Unit, Hospital Universitario de Cabueñes, Spain. 6. Department of Pathology, Hospital Universitario Ramón y Cajal, University of Alcala, Spain. 7. Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, University of Alcala, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS),Spain. 8. Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, University of Alcala, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS),Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III, Spain.
Abstract
BACKGROUND: Missed gastric cancer (MGC) is poorly documented in Mediterranean populations. AIMS: (1) To assess the rate, predictors and survival of MGC. (2) To compare MGC and non-MGC tumors. METHODS: This is a retrospective-cohort study conducted at four centers. MGC was defined as cancer detected within three years after negative esophagogastroduodenoscopy. Gastric adenocarcinomas diagnosed between 2008-2015 were included. Patients with no follow-up were excluded. RESULTS: During the study period 123,395 esophagogastroduodenoscopies were performed, with 1374 gastric cancers being diagnosed (1.1%). A total of 1289 gastric cancers were finally included. The overall rate of MGC was 4.7% (61/1289, 3.7-6%). A negative esophagogastroduodenoscopy in MGC patients was independently associated with PPI therapy (p < 0.001), previous Billroth II anastomosis (p = 0.002), and lack of alarm symptoms (p < 0.001). The most frequent location for MGC was the gastric body(52.4%). MGCs were smaller than non-MGCs (31 vs 41 mm, p = 0.047), more often flat or depressed (p = 0.003) and less likely to be encountered as advanced disease. Overall 2-year survival was similar between MGC (34.1%) and Non-MGC (35.3 %) (p = 0.59). CONCLUSION: MGC accounted for nearly five percent of newly-diagnosed gastric adenocarcinomas. Overall survival was poor and not different between MGC and non-MGC.
BACKGROUND: Missed gastric cancer (MGC) is poorly documented in Mediterranean populations. AIMS: (1) To assess the rate, predictors and survival of MGC. (2) To compare MGC and non-MGC tumors. METHODS: This is a retrospective-cohort study conducted at four centers. MGC was defined as cancer detected within three years after negative esophagogastroduodenoscopy. Gastric adenocarcinomas diagnosed between 2008-2015 were included. Patients with no follow-up were excluded. RESULTS: During the study period 123,395 esophagogastroduodenoscopies were performed, with 1374 gastric cancers being diagnosed (1.1%). A total of 1289 gastric cancers were finally included. The overall rate of MGC was 4.7% (61/1289, 3.7-6%). A negative esophagogastroduodenoscopy in MGC patients was independently associated with PPI therapy (p < 0.001), previous Billroth II anastomosis (p = 0.002), and lack of alarm symptoms (p < 0.001). The most frequent location for MGC was the gastric body(52.4%). MGCs were smaller than non-MGCs (31 vs 41 mm, p = 0.047), more often flat or depressed (p = 0.003) and less likely to be encountered as advanced disease. Overall 2-year survival was similar between MGC (34.1%) and Non-MGC (35.3 %) (p = 0.59). CONCLUSION: MGC accounted for nearly five percent of newly-diagnosed gastric adenocarcinomas. Overall survival was poor and not different between MGC and non-MGC.