Gastric ulceration--a follow-up study.

Two hundred and forty-six patients who were diagnosed in 1976 as having either a benign (180) or a malignant (66) gastric ulcer on endoscopy were reviewed between November 1979 and May 1980. Eight patients were lost to follow-up and 7 had died before healing, leaving 165 patients for review. Eighty-eight (53%) healed on medical treatment and 28 (17%) underwent surgery within 3 months of diagnosis. Subsequent medical treatment healed 107 (65%), while 58 (35%) had operations for non-healing of their gastric ulcers. Twenty-six (39%) of those followed up developed a symptomatic recurrent gastric ulcer. Twelve of these patients required surgery, bringing the final surgical rate to 56%. Ten per cent of benign ulcers were incorrectly thought to be malignant at endoscopy, while 12% of malignant ulcers were thought to be benign. All malignant ulcers were diagnosed within 2 months of the initial endoscopy and no further malignant lesion was found during the follow-up period.