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RETROSPECTIVE STUDY OF ENDOSCOPIC FINDINGS: 250 CASES OF GASTRIC CANCER
Author(s) -
Hosokawa Osamu,
Kaizaki Yasuharu,
Nakaya Takakiyo,
Hinoshita Tetsuya,
Watanabe Kunishige,
Douden Kenji,
Hayashi Hiroyuki
Publication year - 2000
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1046/j.1443-1661.2000.00026.x
Subject(s) - medicine , cancer , endoscopy , stomach , antrum , retrospective cohort study , lesion , gastroenterology , stage (stratigraphy) , gastric antrum , surgery , paleontology , biology
Background : The accuracy of endoscopy for detecting gastric cancer is high but failures may occur if the cancer is not visualized or recognized with gastroscopy. The aim of this study was to understand the reasons why gastroscopy may not detect gastric cancer. Methods : Patients with gastric cancer ( n = 4053) diagnosed between 1979 and 1996 were studied by linking gastroscopic examinations ( n = 111 094). Endoscopic records were reviewed in 250 patients who were diagnosed with gastric cancer but had not been diagnosed as such on the examination within the previous 3 years. Results : In 33 patients (13.2%) gastric cancer was detected at the advanced stage. The percentage of advanced cancer was significantly higher on the cardia and the gastric body than it was on the angulus and the antrum. In 107 patients (42.8%) no lesion was identified after reviewing endoscopic records. In 102 patients (40.8%) marked lesions were present but had not been diagnosed as such. In 41 patients (16.4%) gastric cancer may have been overlooked but due to a lack of photographic documentation in the specific areas, these findings were not confirmed. The percentage of the indeterminate examinations was significantly higher in lesions on the remnant stomach and the cardia than in other areas. Conclusion : In order to reduce the proportion of the advanced gastric cancer to under 20%, repeated endoscopic examinations were recommended within 2 years even if any suspicious lesions could not be detected by the initial examination.