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Gastrointest Endosc. 2012 Jan;75(1):39-46. doi: 10.1016/j.gie.2011.08.030. Epub 2011 Oct 21.

Long-term effect of Helicobacter pylori eradication on the development of metachronous gastric cancer after endoscopic resection of early gastric cancer.

Author information

1
Department of Medicine and Clinical Science, Kyushu University, Fukuoka, Japan.

Abstract

BACKGROUND:

A prospective, randomized trial proved that Helicobacter pylori eradication significantly reduces the incidence of metachronous gastric cancer during a 3-year follow-up.

OBJECTIVE:

To investigate the long-term effect of H pylori eradication on the incidence of metachronous gastric cancer after endoscopic resection of early gastric cancer.

DESIGN:

Retrospective, multicenter study.

SETTING:

Kyushu University Hospital and 6 other hospitals in Fukuoka Prefecture, Japan.

PATIENTS AND INTERVENTIONS:

Follow-up data for 268 H pylori-positive patients who had undergone endoscopic resection of early gastric cancer were retrospectively investigated. A total of 177 patients underwent successful H pylori eradication (eradicated group), whereas 91 had persistent H pylori infection (persistent group).

MAIN OUTCOME MEASUREMENTS:

The incidence of metachronous gastric cancer was compared in these 2 groups.

RESULTS:

When the follow-up period was censored at 5 years, the incidence rate in the eradicated group was lower than that observed in the persistent group (P = .007). During the overall follow-up period ranging from 1.1 to 11.1 years (median 3.0 years), metachronous gastric cancer developed in 13 patients (14.3%) in the persistent group and in 15 patients (8.5%) in the eradicated group (P = .262, log-rank test). Based on a multivariate logistic regression analysis, baseline severe mucosal atrophy and a follow-up of more than 5 years were found to be independent risk factors for the development of metachronous gastric cancer.

LIMITATIONS:

Retrospective study.

CONCLUSIONS:

H pylori eradication does not reduce the incidence of metachronous gastric cancer. H pylori eradication should be performed before the progression of gastric mucosal atrophy.

PMID:
22018552
DOI:
10.1016/j.gie.2011.08.030
[Indexed for MEDLINE]

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