Relative value of repeat gastric ulcer surveillance gastroscopy in diagnosing gastric cancer

Hopper, Andrew N.; Stephens, Michael; Lewis, Wyn G.; Blackshaw, Guy; Morgan, Matthew A.; Thompson, Ian; Allison, M. E. M.

doi:10.1007/s10120-006-0385-4

Cited by 24 publications

(19 citation statements)

References 16 publications

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“…Whether all gastric ulcers should be surveyed until healing is still being discussed [9][10][11][12][13]. There are also contradictory results about the improvement of survival secondary to an endoscopic follow-up strategy [13,14].…”

Section: Introductionmentioning

confidence: 99%

Follow-up endoscopy for benign-appearing gastric ulcers has no additive value in detecting malignancy

Gielisse

Kuyvenhoven

2014

Gastric Cancer

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Objective To determine the diagnostic accuracy of endoscopic follow-up for gastric ulcers. Methods All cases of gastric ulcers diagnosed at our teaching hospital between September 2005 and November 2011 were reviewed. The cases were selected by using ENDOBASE, an endoscopy documentation system. The characteristics of the ulcers and their histology were analysed. Results During the study period 321 cases with a gastric ulcer were diagnosed, including 214 benign ulcers (67 %) and 107 malignant ulcers (33 %). The mean age of the population was 71 years. In 200 patients (62 %) the ulcers were classified as benign appearing at the first endoscopy. However, in five of these patients, the ulcers eventually were malignant. In all of these five patients the index gastroscopy revealed a non-benign histology. Therefore, the sensitivity of a benign appearance of the ulcer in combination with histology at the first endoscopy is 100 % to rule out malignancy. In 121 patients (38 %) the ulcers were explicitly labelled as potentially malignant in the report of the first endoscopy. Of these potentially malignant-appearing ulcers, 102 (84 %) were indeed malignant as confirmed by histology. The other 19 ulcers (16 %) were benign at follow-up. The sensitivity of the three potential malignant characteristics at endoscopy was: dirty base 79 %, elevated border 94 % and irregular border 91 %. The specificity was 93, 82 and 89 %, respectively. The median diameter of the ulcers was significantly higher in the malignant group compared to the benign ulcer group (p \ 0.0001). The accuracy of endoscopic malignancy diagnosis was as follows: sensitivity of 0.98 and specificity 0.84, positive predictive value 0.84 and negative predictive value 0.98. In total, 546 gastroscopies were performed in these 321 patients, of which 225 were follow-up endoscopies. By not monitoring ulcers considered benign in both appearance and histology, 173 gastroscopies would not have been performed, resulting in a decline of 77 % of the follow-up endoscopies performed. Conclusion Endoscopic follow-up of gastric ulcers considered benign by appearance and with benign histology showed no additive value in detecting unsuspected malignancy in this study. This strategy could reduce health costs and save distress to patients.

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Section: Introductionmentioning

confidence: 99%

Follow-up endoscopy for benign-appearing gastric ulcers has no additive value in detecting malignancy

Gielisse

Kuyvenhoven

2014

Gastric Cancer

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“…Hopper and colleagues reported the role of long-term follow-up of patients who were diagnosed as benign gastric ulcer in their initial endoscopic investigation. Of 277 who underwent elective follow-up endoscopic assessment, 4.3% were shown to have a malignant ulcer during the follow-up [84]. Another study from Japan reexamined 3,672 high-risk patients by gastroscopy 1-3 years following an apparently negative endoscopy.…”

Section: Clinical Implications and Future Horizonmentioning

confidence: 94%

“…This has led to an alternative proposal that endoscopic follow-up study is restricted to cases of uncertain or malignant endoscopic impression [83]. However, two recent studies from the areas of both high and low gastric carcinoma incidence have shown that follow-up for patients with benign-looking gastric ulcer is necessary at least until it is completely healed [84][85]. Hopper and colleagues reported the role of long-term follow-up of patients who were diagnosed as benign gastric ulcer in their initial endoscopic investigation.…”

Section: Clinical Implications and Future Horizonmentioning

confidence: 97%

The Risk of Gastric Cancer in Patients with Duodenal and Gastric Ulcer: Research Progresses and Clinical Implications

Zhang

2007

J Gastrointest Canc

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“…In some countries, including Korea, surveillance endoscopy is recommended after treatment of a benign gastric ulcer (18). Original Article…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of endoscopic surveillance for gastric ulcers in populations with a high prevalence of gastric cancer

Lee¹,

Han²,

Cho³

et al. 2016

Turk J Gastroenterol

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Relative value of repeat gastric ulcer surveillance gastroscopy in diagnosing gastric cancer

Cited by 24 publications

References 16 publications

Follow-up endoscopy for benign-appearing gastric ulcers has no additive value in detecting malignancy

Follow-up endoscopy for benign-appearing gastric ulcers has no additive value in detecting malignancy

The Risk of Gastric Cancer in Patients with Duodenal and Gastric Ulcer: Research Progresses and Clinical Implications

Clinical outcomes of endoscopic surveillance for gastric ulcers in populations with a high prevalence of gastric cancer

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