Occurrence and risk factors of missed carcinoma in the upper gastrointestinal tract (PEUGIC) 2013– 2023: retrospective observational study

Czech version

Authors: J. Langner ¹; I. Mikoviny Kajzrlíková ¹; P. Vítek ^1,2; B. Hořavová ³; M. Chrostek ⁴
Authors‘ workplace: Interní oddělení, Beskydské Gastrocentrum, Nemocnice ve Frýdku-Místku, příspěvková organizace ¹; Katedra interních oborů, Lékařská fakulta OU, Ostrava ²; Oddělení patologie, Nemocnice ve Frýdku-Místku, příspěvková organizace ³; Chirurgické oddělení, Nemocnice ve Frýdku-Místku, příspěvková organizace ⁴
Published in: Gastroent Hepatol 2025; 79(3): 159-164
Category: Original Article
doi: https://doi.org/10.48095/ccgh2025159

Overview

Background: Post-endoscopy upper gastrointestinal cancer (PEUGIC) is defined as carcinoma in the upper gastrointestinal (GI) tract, which was preceded by negative upper endoscopy in the past 3 years. According to current knowledge, the rate of PEUGIC is an important parameter of endoscopic quality and should not exceed 10%. The aim of this study was to evaluate the occurrence and risk factors of PEUGIC at a non-university hospital in Frýdek-Místek between 2013 and 2023. Methodology: This is a retrospective analysis of the patients diagnosed with upper GI cancer from January 2013 to December 2023. The data analyzed included family history of upper GI cancer, indications of the examination, therapy, tumor location, and histological type. Risk factors for PEUGIC were calculated using the Chi-squared test and Fisher‘s exact test, with P < 0.05 considered significant. Results: During the study period, a total of 22,727 gastroscopies were performed in total, and 122 patients were diagnosed with upper GI cancer (88 men and 34 women), including 35 esophageal tumors, 80 gastric tumors, and 7 duodenal tumors. Family history of upper GI tumors was reported in 10 patients. PEUGIC was identified in 12 patients (9.84%, 9 men and 3 women, mean age 69.25 years), including 6 in the esophagus, 5 in the stomach, and 1 in the duodenum. Two patients had early detection as part of adequate surveillance (Barrett‘s esophagus, post-polypectomy). Thus, we can evaluate 10 patients as true PEUGIC (8.20%). Tumor location, histology, male gender, or family history of upper GI tumors were not statistically significant risk factors for detecting PEUGIC. Conclusion: The overall rate of PEUGIC at our institution over the 11-year study period was 9.86%, and without early detected lesions as part of adequate surveillance, it was 8.20%. Early detection of PEUGIC indicated poorer endoscopy quality that needs to be distinguished from early detection of carcinoma with adequate surveillance.

Keywords:

gastrointestinal neoplasms – esophageal neoplasms – stomach neoplasms – early detection of cancer – quality indicators

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ORCID autorů

J. Langner 0009-0009-9570-4468,

I. Mikoviny Kajzrliková 0000-0001-6824-5440,

P. Vítek 0000-0001-5796-9128,

B. Hořavová 0000-0002-9309-3730,

M. Chrostek 0000-0002-2040-9415.

Doručeno/Submitted: 3. 4. 2025

Přijato/Accepted: 30. 4. 2025

Korespondenční autor

MUDr. Jakub Langner

Interní oddělení

Beskydské Gastrocentrum