%0 Journal Article
%T Giant gastric ulcers: Malignancy yield and predictors from a 10
%A Bjorn J Rembacken
%A Lea Tomos
%A Mohammed El-Feki
%A Noor Mohammed
%A Richard Lord
%A Venkat Subramanian
%J United European Gastroenterology Journal
%@ 2050-6414
%D 2018
%R 10.1177/2050640618770013
%X Gastric cancer is known to reside in some gastric ulcers but what predicts this association is still unclear. Historically it has been thought that the increasing size of gastric ulcers may be a predictor for harbouring malignancy. Giant gastric ulcers are arbitrarily defined as ≡3ˋcm. The aim of this retrospective study was to examine patients with giant gastric ulcers within a single tertiary centre over a 10-year period. Our primary outcomes included the malignancy yield in giant gastric ulcers and to determine if any demographic, clinical or endoscopic predictors for malignancy exist. Secondary outcomes included the 30-day and 12-month mortality. Patients with giant gastric ulcers ≡3ˋcm presenting from September 2005 to December 2015 were included in the study. Malignancy yield was obtained by looking at histology reports. Predictors for malignancy were tested using binary logistic regression, after demographic, clinical and endoscopic variables were tested using univariate analysis and for collinearity. A cohort of 111 patients was included for the final analysis. Forty-two giant gastric ulcers were malignant, equating to a yield of 37.8% (95% CI 28.8每46.8). Binary logistic regression revealed predictors for malignancy included: ulcer location being within the fundus, cardia or incisura (odds ratio (OR) 4.417; 95% CI 1.10每17.76; Pˋ=ˋ0.036); younger age of patient (OR 0.202; 95% CI 0.06每0.71; Pˋ=ˋ0.013); and endoscopic ＆non-suspicion＊ (OR 0.138; 95% CI 0.049每0.39; Pˋ<ˋ0.001). Patient's 12-month mortality for giant gastric ulcer was 61.9% (26/42) for malignant and 21.9% (11/73) for benign histology. We have shown a high malignancy yield of 37.8% (95% CI 28.8每46.8) and a 12-month mortality of 61.9% for malignant giant gastric ulcers and 21.9% for benign giant gastric ulcers. Predictors for malignancy in patients with giant gastric ulcers include ulcer location, patient's age and endoscopist's ＆suspicion＊ during endoscopy
%K Giant gastric ulcers
%K gastric ulcer
%K gastric cancer
%K malignancy risk giant gastric ulcers
%K gastric ulcer mortality
%U https://journals.sagepub.com/doi/full/10.1177/2050640618770013