title: Eradication of Helicobacter pylori for primary gastric cancer and secondary gastric cancer after endoscopic mucosal resection.
abstract: Because most gastric cancers develop from a background of Helicobacter pylori-infected gastric mucosa, H. pylori plays an important role in gastric carcinogenesis. Therefore, eradication of H. pylori may inhibit the incidence of gastric cancers. In experimental studies, H. pylori eradication has proved to act as a prophylaxis against gastric cancer. However, the results of recent randomized controlled studies are absolutely contradictory. In Japan, mucosal gastric cancer is usually resected by endoscopic treatment. As only a small part of the gastric mucosa is resected, secondary gastric cancer after endoscopic resection of the primary gastric cancer often develops at another site in the stomach. A nonrandomized Japanese study involving 132 early gastric cancer patients reported that eradication of H. pylori after endoscopic resection tended to reduce the development of secondary gastric cancer. Also, a retrospective multicenter survey indicated that the incidence rate of secondary gastric cancer in H. pylori-eradicated patients was about one-third that among patients in the non eradication group. We conducted a large-scale multicenter randomized trial to confirm the effect of H. pylori eradication on secondary and residual gastric cancer after endoscopic resection. This study was begun in 2003 and is ongoing at present. Diagnosis of a new carcinoma at another site of the stomach is defined as the primary end point, and recurrence of tumors at the resection site as a secondary end point. A total of 542 subjects have been enrolled in the study. This study will have the statistical power to demonstrate whether H. pylori eradication decreases the incidence and recurrence of gastric cancer.
authors.affiliation: Division of Endoscopy, Hokkaido University Hospital, North 14, West 5, Kita-Ku, Sapporo, 060-8638, Japan.
authors.forename: Motosugu
authors.initials: M
authors.lastname: Kato
authors.forename: Masahiro
authors.initials: M
authors.lastname: Asaka
authors.forename: Shouko
authors.initials: S
authors.lastname: Ono
authors.forename: Manabu
authors.initials: M
authors.lastname: Nakagawa
authors.forename: Souichi
authors.initials: S
authors.lastname: Nakagawa
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Shimizu
authors.forename: Makoto
authors.initials: M
authors.lastname: Chuma
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawakami
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Komatsu
authors.forename: Shuhei
authors.initials: S
authors.lastname: Hige
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takeda
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004724:Endoscopy; D005753:Gastric Mucosa / Q000601:surgery*; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D007564:Japan; D009364:Neoplasm Recurrence, Local / Q000382:microbiology / Q000517:prevention & control*; D011446:Prospective Studies; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000382:microbiology / Q000517:prevention & control* / Q000601:surgery
chemical_list: D000900:Anti-Bacterial Agents