PMID- 31080603 OWN - NLM STAT- MEDLINE DCOM- 20200422 LR - 20200422 IS - 2050-6406 (Print) IS - 2050-6414 (Electronic) IS - 2050-6406 (Linking) VI - 7 IP - 2 DP - 2019 Mar TI - Rate of missed oesophageal cancer at routine endoscopy and survival outcomes: A multicentric cohort study. PG - 189-198 LID - 10.1177/2050640618811477 [doi] AB - BACKGROUND: Missed oesophageal cancer (MEC) at upper gastrointestinal endoscopy (UGE) is poorly documented. OBJECTIVE: The objectives of this study were: (1) to assess the rate, predictors and survival of MEC; (2) to compare MEC and non-MEC tumours. METHODS: This was a retrospective cohort study conducted at four tertiary centres. Oesophageal cancers (ECs) diagnosed between 2008 and 2015 were included. Patients with a premalignant condition (Barrett, achalasia), prior diagnosis of EC or oesophagogastric junction tumour of gastric origin were excluded. MEC was defined as EC detected within 36 months after negative UGE. RESULTS: 123,395 UGEs were performed during the study period, with 502 ECs being diagnosed (0.4%). A total of 391 ECs were finally included. Overall MEC rate was 6.4% (95% confidence intervals (CI): 4.4-9.3%). The interval between negative and diagnostic UGE was less than 2 years in 84% of the cases. Multivariate analysis showed that a negative endoscopy was associated with proton pump inhibitor (PPI) therapy and less experienced endoscopists. MEC was smaller than non-MEC at diagnosis (25 versus 40 mm, p = 0.021), more often flat or depressed (p = 0.013) and less frequently diagnosed as metastatic disease (p = 0.013). Overall 2-year survival rate was similar for MEC (20%) and non-MEC (24.1%) (p = 0.95). CONCLUSIONS: MEC accounted for 6.4% of all ECs and was associated with poor survival. High-quality UGE and awareness of MEC may help to reduce its incidence. FAU - Rodriguez de Santiago, Enrique AU - Rodriguez de Santiago E AD - Department of Gastroenterology and Hepatology, Hospital Universitario Ramon y Cajal, University of Alcala, Madrid, Spain. AD - Instituto Ramon y Cajal de Investigacion Biosanitaria (IRYCIS), Madrid, Spain. FAU - Hernanz, Nerea AU - Hernanz N AD - Department of Gastroenterology and Hepatology, Hospital Universitario Ramon y Cajal, University of Alcala, Madrid, Spain. FAU - Marcos-Prieto, Hector Miguel AU - Marcos-Prieto HM AD - Gastroenterology Department, Hospital Universitario de Salamanca, University of Salamanca, IBSAL (Instituto de Investigacion Biomedica de Salamanca), Salamanca, Spain. FAU - De-Jorge-Turrion, Miguel Angel AU - De-Jorge-Turrion MA AD - Department of Gastroenterology and Hepatology, Hospital Universitario Central de Asturias, Oviedo, Spain. FAU - Barreiro-Alonso, Eva AU - Barreiro-Alonso E AD - Gastroenterology Unit, Hospital Universitario de Cabuenes, Gijon, Spain. FAU - Rodriguez-Escaja, Carlos AU - Rodriguez-Escaja C AD - Department of Gastroenterology and Hepatology, Hospital Universitario Central de Asturias, Oviedo, Spain. FAU - Jimenez-Jurado, Andrea AU - Jimenez-Jurado A AD - Gastroenterology Department, Hospital Universitario de Salamanca, University of Salamanca, IBSAL (Instituto de Investigacion Biomedica de Salamanca), Salamanca, Spain. FAU - Sierra-Morales, Maria AU - Sierra-Morales M AD - Department of Gastroenterology and Hepatology, Hospital Universitario Ramon y Cajal, University of Alcala, Madrid, Spain. FAU - Perez-Valle, Isabel AU - Perez-Valle I AD - Gastroenterology Unit, Hospital Universitario de Cabuenes, Gijon, Spain. FAU - Machado-Volpato, Nadja AU - Machado-Volpato N AD - Department of Gastroenterology and Hepatology, Hospital Universitario Ramon y Cajal, University of Alcala, Madrid, Spain. FAU - Garcia-Prada, Maria AU - Garcia-Prada M AD - Gastroenterology Department, Hospital Universitario de Salamanca, University of Salamanca, IBSAL (Instituto de Investigacion Biomedica de Salamanca), Salamanca, Spain. FAU - Nunez-Gomez, Laura AU - Nunez-Gomez L AD - Department of Gastroenterology and Hepatology, Hospital Universitario Ramon y Cajal, University of Alcala, Madrid, Spain. FAU - Castano-Garcia, Andres AU - Castano-Garcia A AD - Gastroenterology Department, Hospital Universitario de Salamanca, University of Salamanca, IBSAL (Instituto de Investigacion Biomedica de Salamanca), Salamanca, Spain. FAU - Garcia Garcia de Paredes, Ana AU - Garcia Garcia de Paredes A AD - Department of Gastroenterology and Hepatology, Hospital Universitario Ramon y Cajal, University of Alcala, Madrid, Spain. FAU - Penas, Beatriz AU - Penas B AD - Department of Gastroenterology and Hepatology, Hospital Universitario Ramon y Cajal, University of Alcala, Madrid, Spain. AD - Instituto Ramon y Cajal de Investigacion Biosanitaria (IRYCIS), Madrid, Spain. FAU - Vazquez-Sequeiros, Enrique AU - Vazquez-Sequeiros E AD - Department of Gastroenterology and Hepatology, Hospital Universitario Ramon y Cajal, University of Alcala, Madrid, Spain. AD - Instituto Ramon y Cajal de Investigacion Biosanitaria (IRYCIS), Madrid, Spain. FAU - Albillos, Agustin AU - Albillos A AD - Department of Gastroenterology and Hepatology, Hospital Universitario Ramon y Cajal, University of Alcala, Madrid, Spain. AD - Instituto Ramon y Cajal de Investigacion Biosanitaria (IRYCIS), Madrid, Spain. AD - Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III, Madrid, Spain. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20181031 PL - England TA - United European Gastroenterol J JT - United European gastroenterology journal JID - 101606807 MH - Aged MH - Aged, 80 and over MH - Cohort Studies MH - *Endoscopy, Digestive System/methods MH - Esophageal Neoplasms/*diagnosis/epidemiology/*mortality/therapy MH - Female MH - Humans MH - Male MH - Middle Aged MH - Missed Diagnosis MH - Retrospective Studies MH - Survival Analysis PMC - PMC6498796 OTO - NOTNLM OT - Missed cancer OT - oesophageal neoplasms OT - oesophagitis OT - oesophagogastroduodenoscopy OT - survival EDAT- 2019/05/14 06:00 MHDA- 2019/05/14 06:01 PMCR- 2019/03/01 CRDT- 2019/05/14 06:00 PHST- 2018/05/15 00:00 [received] PHST- 2018/10/15 00:00 [accepted] PHST- 2019/05/14 06:00 [entrez] PHST- 2019/05/14 06:00 [pubmed] PHST- 2019/05/14 06:01 [medline] PHST- 2019/03/01 00:00 [pmc-release] AID - 10.1177_2050640618811477 [pii] AID - 10.1177/2050640618811477 [doi] PST - ppublish SO - United European Gastroenterol J. 2019 Mar;7(2):189-198. doi: 10.1177/2050640618811477. Epub 2018 Oct 31.