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


METHODS
Retrospective, multicenter study.


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


METHODS
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).


METHODS
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.


CONCLUSIONS
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.
Department of Medicine and Clinical Science, Kyushu University, Fukuoka, Japan.
Yuji
Y
Maehata
Shotaro
S
Nakamura
Kiyoshi
K
Fujisawa
Motohiro
M
Esaki
Tomohiko
T
Moriyama
Kouichi
K
Asano
Yuta
Y
Fuyuno
Kan
K
Yamaguchi
Issei
I
Egashira
Hyonji
H
Kim
Motonobu
M
Kanda
Minako
M
Hirahashi
Takayuki
T
Matsumoto
D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D060740:Disease Eradication; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology / Q000601:surgery; D005757:Gastritis, Atrophic / Q000150:complications; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000517:prevention & control; D016480:Helicobacter pylori; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016609:Neoplasms, Second Primary / Q000453:epidemiology* / Q000473:pathology*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D013997:Time Factors