Natural history of gastric cancer from a retrospective review of endoscopic images of older patients with interval gastric cancer

摘要

Aim Interval gastric cancers (IGC) are defined as those diagnosed after negative results of endoscopy carried out within the past 10?years. We aimed to investigate the characteristics of IGC and the natural history of gastric cancer (GC) from a retrospective view of endoscopic images of older patients with IGC. Methods We retrospectively reviewed endoscopic images of 240 patients with GC who were aged 60?years. We compared past endoscopic images with newer ones, in which GC was diagnosed. IGC were classified into two categories: missed cancers and new cancers. Results Of the 240 patients with GC, 32 had past endoscopic images that qualified for a precise review. A total of 14 cases involved new cancers, whereas 18 involved missed cancers. Most of the IGC were stage?I for at least 2?years; however, a small subset was unresectable at 2?years after a negative endoscopy. Furthermore, the rate of endoscopic treatment was significantly higher for IGC compared with that for non‐IGC. Conclusions In people aged 60?years, most IGC remain in an early stage for at least 2?years; however, at 2?years after a negative endoscopy, some are unresectable. These results suggest that most early‐stage GC will not develop into advanced cancers within 2?years; thus, a 2‐year interval might be within the permissible range for patients with negative endoscopy results for any lesions. Geriatr Gerontol Int 2018; 18: 997–1002