title: Helicobacter pyloriand gastrointestinal symptoms in diagnostics and adjuvant chemotherapy of colorectal cancer.
abstract: 5-Fluorouracil (5-FU)-based chemotherapy is the mainstay of adjuvant treatment for colorectal cancer (CRC). Few studies have exploredHelicobacter pylori(H. pylori)-associated gastrointestinal symptoms in the diagnosis of CRC, and the association betweenH. pyloriinfection and gastrointestinal toxicity during adjuvant chemotherapy in CRC. Seventy-nine CRC patients were randomised in a prospective clinical trial to receive 5-FU and leucovorin administered as bolus injection (Mayo regimen) or continuous infusion (simplified de Gramont regimen).H. pyloriantibodies were analysed at baseline, twice monthly during treatment and after treatment up to 12 months. Thirty-seven patients (47%) wereH. pylori-seronegative at baseline. There was no significant association between baselineH. pyloriseropositivity (n=42; 53%) and oro-gastrointestinal toxicity during chemotherapy. The median time from symptom onset of CRC to surgery was significantly longer in patients withH. pyloriinfection (median time, 6 vs. 5 months; P=0.012). Functional dyspeptic symptoms at presentation significantly delayed diagnosis (median time, 7.5 vs. 5 months; P=0.035), whereas anaemia, bowel symptoms, occlusion, blood in the stool, infection and hypolactasia did not. We conclude that there is no association betweenH. pyloristatus and gastrointestinal toxicity in CRC patients during chemotherapy. Dyspeptic symptoms and presence ofH. pylorimay delay the diagnosis of CRC. (www.controlled-trials.com/ISRCTN98405441).
authors.affiliation: Department of Oncology, Helsinki University Central Hospital, Helsinki 00029, Finland.
authors.forename: Leena-Maija
authors.initials: LM
authors.lastname: Soveri
authors.affiliation: Department of Oncology, Helsinki University Central Hospital, Helsinki 00029, Finland ; Clinical Department, University of Helsinki, Helsinki 00014, Finland.
authors.forename: Pia
authors.initials: P
authors.lastname: Osterlund
authors.affiliation: Department of Oncology, Helsinki University Central Hospital, Helsinki 00029, Finland.
authors.forename: Tarja
authors.initials: T
authors.lastname: Ruotsalainen
authors.affiliation: STAT-Consulting, Nokia 37130, Finland.
authors.forename: Tuija
authors.initials: T
authors.lastname: Poussa
authors.affiliation: Department of Bacteriology and Immunology, Haartman Institute, University of Helsinki, Helsinki 00014, Finland ; HUSLAB, Helsinki University Central Hospital Laboratory, Helsinki 00029, Finland ; Uppsala University, Department of Medical Sciences, Uppsala 75185, Sweden.
authors.forename: Hilpi
authors.initials: H
authors.lastname: Rautelin
authors.affiliation: Department of Oncology, Helsinki University Central Hospital, Helsinki 00029, Finland ; Clinical Department, University of Helsinki, Helsinki 00014, Finland.
authors.forename: Petri
authors.initials: P
authors.lastname: Bono
keywords: Helicobacter pylori; adjuvant treatment; colorectal cancer; gastrointestinal symptoms