PTU-017 giant gastric ulcers: malignancy yield and predictors from a 10-year retrospective single centre cohort. (8th June 2018) - Lord, Richard
Abstract : Introductions: Gastric cancer is known to reside in some gastric ulcers but what predicts this association is still unclear. Historically it was thought that increasing size of gastric ulcers maybe a predictor for harbouring malignancy. Little is known about this risk in giant gastric ulcers (>3 cms). We looked at malignancy yield in giant gastric ulcers and determined if any demographic, clinical or endoscopic predictors for malignancy exist. Secondary outcomes included the 30 day and 12 month mortality. Methods: This was a retrospective study including patients with giant gastric ulcers dating from September 2005 to December 2015. Predictors for malignancy were determined using binary logistic regression, after demographic, clinical and endoscopic variables were tested using univariate analysis and checking for collinearity. Results: A cohort of 111 patients was included for the final analysis. 42 giant gastric ulcers were malignant, equating to a yield of 37.8% (95% CI 28.8–46.8). Binary logistic regression analysis revealed predictors for malignancy were ulcer location (odds ratio (OR 4.417; 95% CI 1.10–17.76; p=0.036), younger age of patient (OR 0.202; 95% CI 0.06–0.71; p=0.013) and endoscopic 'non-suspicion' (OR 0.138; 95% CI 0.049–0.39; p<0.001). Patient's 12 month mortality for giant gastric ulcer was 61.9% (26/42) for malignant giant ulcers and 21.9% (11/73) for benign histology. Conclusion: Giant gastric ulcers have a high malignancy yield and associated with significant 12 month mortality. Predictors for malignancy include ulcer location, patient's age and endoscopist's 'non-suspicion' during endoscopy.