Clinical features of gastric cancer discovered after successful eradication of Helicobacter pylori: results from a 9-year prospective follow-up study in Japan.
BACKGROUND
Eradication of Helicobacter pylori is expected to prevent the development of gastric cancer. However, gastric cancer is sometimes discovered after successful eradication of H. pylori.


OBJECTIVE
To conduct a prospective study to determine the clinical features of patients who underwent successful eradication and were later diagnosed with gastric cancer.


METHODS
A total of 1787 patients (1299 males and 488 females; mean age, 58.2 years; range: 15-84) who underwent successful eradication therapy between April 1994 and March 2001 were our study subjects.


RESULTS
Gastric cancer occurred at a rate of 1.1% (20 of 1787) during the follow-up period. Gastric cancer comprises six of 105 (5.7%) with early gastric cancer after endoscopic resection, 12 of 575 (2.1%) with gastric ulcer and two of 453 (0.4%) with atrophic gastritis. Gastric cancer did not develop in any patient with duodenal ulcer. All patients with gastric cancer had baseline severe atrophic gastritis in the corpus.


CONCLUSIONS
Careful endoscopic examination is necessary even after successful eradication of H. pylori in patients with early gastric cancer or gastric ulcer with severe mucosal atrophy in the corpus.
Kamada
T
T
Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School, Matsushima, Kurashiki, Japan. tkamada@med.kawasaki-m.ac.jp
Hata
J
J
Sugiu
K
K
Kusunoki
H
H
Ito
M
M
Tanaka
S
S
Inoue
K
K
Kawamura
Y
Y
Chayama
K
K
Haruma
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000150:complications* / Q000473:pathology / Q000628:therapy; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000382:microbiology* / Q000473:pathology