Blackshaw, G.; Edwards, P.; Barry, J.; Gent, C.; Allison, M.; Lewis, W.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA80
Academic Journal
Aims: The aim of our study was to determine the outcomes of patients admitted to hospital as emergencies with acute complications of their undiagnosed cancers, and to compare their outcomes with those of patients diagnosed via conventional outpatient referrals. Methods: Eighty-eight patients (median age 73 years, 55 months) admitted to hospital as emergencies with acute complications of their undiagnosed gastric cancers were studied prospectively and compared with 170 patients (71 years, 114 months) with gastric cancer diagnosed as out patients or open access endoscopy. Results: In a multivariate analysis, acute presentation (HR 2.70, 95% CI 2.07 to 3.33, p = 0.002) and the stage of gastric cancer (HR 1.773, 95% CI 1.457 to 2.089, p < 0.0001) were found to be significantly and independently associated with poor survival. Conclusion: Although the one in three patients presenting acutely had not suffered undue diagnostic delay, they were less likely to undergo potentially curative surgery and to survive long term. Acute presentation with gastric cancer remains common, and if the findings of this study are representative, is an independent and significant prognostic marker of an aggressive form of gastric cancer.


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