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

Özet

Background/Aims: Although surveillance endoscopy is recommended after the treatment of a benign gastric ulcer in Korea, improved survival, secondary to an endoscopic follow-up strategy, is controversial. Thus, the aim of this study was to understand the results of gastric ulcer surveillance endoscopy and to individualize surveillance endoscopy by analyzing known risk factors for gastric cancer.Materials and Methods: In total, 599 (M:F=424:175, median age=55.4 years) patients who were diagnosed with a gastric ulcer and who underwent follow-up endoscopy between January 2003 and August 2014 were retrospectively enrolled in this study. The final results and risk factors of follow-up endoscopy were analyzed.Results: Multivariate analysis of the data between the benign and malignant ulcer groups (benign: malignant=575:24) showed that an elevated border and irregular margins, among other risk factors, were significant indicators of malignancy (p<0.05). Of the 599 patients, 15 (2.5%) were histologically malignant based on the first biopsy results. Nine (1.5%) patients had malignant ulcers on surveillance endoscopy, and all nine were found to have atypia or dysplasia on the first biopsy. Eight of the nine patients had malignant endoscopic features.Conclusion: Surveillance endoscopy for gastric ulcers may be unnecessary, except in cases of malignant and pre-malignant endoscopic features on the initial endoscopy