Characteristics and consequences of missed gastric cancer: A multicentric cohort study.

Abstract

BACKGROUND\nMissed gastric cancer (MGC) is poorly documented in Mediterranean populations.\n\n\nAIMS\n(1) To assess the rate, predictors and survival of MGC. (2) To compare MGC and non-MGC tumors.\n\n\nMETHODS\nThis 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.\n\n\nRESULTS\nDuring 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\u202f<\u202f0.001), previous Billroth II anastomosis (p\u202f=\u202f0.002), and lack of alarm symptoms (p\u202f<\u202f0.001). The most frequent location for MGC was the gastric body(52.4%). MGCs were smaller than non-MGCs (31 vs 41 mm, p\u202f=\u202f0.047), more often flat or depressed (p\u202f=\u202f0.003) 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\u202f=\u202f0.59).\n\n\nCONCLUSION\nMGC accounted for nearly five percent of newly-diagnosed gastric adenocarcinomas. Overall survival was poor and not different between MGC and non-MGC.