Survival outcomes and rate of missed upper gastrointestinal cancers at routine endoscopy: a single centre retrospective cohort study

Eur J Gastroenterol Hepatol. 2020 Oct;32(10):1312-1321. doi: 10.1097/MEG.0000000000001863.

Abstract

Objectives: Data on the long-term survival outcome of patients with missed upper gastrointestinal cancers (MUGC) is lacking. Retrospective studies have found no difference in 1- and 2-year survival among patients with missed gastric and oesophageal cancers; we thus aimed to assess 3-year survival of patients with MUGC at oesophagogastroduodenoscopy.

Methods: This was a retrospective cohort study conducted at a single tertiary endoscopy centre. All oesophagogastroduodenoscopies performed between January 2007 and December 2015 were included in the study. The endoscopy database was cross-matched with the Slovenian Cancer Registry database. Missed cancers were defined as those diagnosed within 36 months after a negative oesophagogastroduodenoscopy.

Results: During the study period, 29 617 oesophagogastroduodenoscopies were performed. In total, 422 upper gastrointestinal cancers were diagnosed and the rate of missed gastric cancers was 7.3% (95% CI, 4.9-10.6%) (26/354), and 4.4% (95% CI, 0.9-12.4%) for oesophageal cancers (3/68). Three-year survival of patients with MUGC was shorter than that of those with non-MUGC, being 12% (95% CI, 1-25%) vs. 31% (95% CI, 26-36%) (P = 0.043) for gastric and 0 vs. 9% (95% CI, 1-17%) (P = 0.121) for oesophageal cancer.

Conclusion: Missed gastric cancer during oesophagogastroduodenoscopy may be associated with shorter 3-year survival compared to patients whose gastric cancer was diagnosed at index oesophagogastroduodenoscopy.

MeSH terms

  • Endoscopy
  • Esophageal Neoplasms*
  • Gastrointestinal Neoplasms* / diagnosis
  • Humans
  • Retrospective Studies
  • Stomach Neoplasms* / diagnosis