title: Risk Factors for TB in Patients With Early Gastric Cancer: Is Gastrectomy a Significant Risk Factor for TB?
abstract: BACKGROUND
  Gastrectomy is known as one of the risk factors for TB. However, there is no study about the association between TB development and gastrectomy performed in patients with early gastric cancer (EGC). This study evaluated conventional risk factors, including gastrectomy, associated with TB development in patients with EGC.
  
  
  METHODS
  A retrospective cohort study was performed using the database of the Center for Gastric Cancer of the National Cancer Center, Korea. The patients with EGC whose T1 lesions were pathologically confirmed by gastrectomy or endoscopic resection were included.
  
  
  RESULTS
  A total of 1,935 patients constituted the EGC cohort. Of these, 1,495 patients were confirmed by gastrectomy and the remaining 440 by endoscopic resection. The median follow-up duration was 4.9 years, and during this period, 31 cases of TB developed (TB incidence, 334/100,000 person-years; 95% CI, 227-475). Multivariate Cox regression analysis showed that old TB lesion on chest radiograph and gastrectomy were significant risk factors (hazard ratio [HR], 5.01; 95% CI, 2.44-10.28; P < .001; and HR, 8.95; 95% CI, 1.22-65.78; P = .031; respectively). In the gastrectomy subgroup, old TB lesion and ≥ 15% reduction in weight and albumin level about 1 year after gastrectomy were significant risk factors (HR, 4.80; 95% CI, 2.26-10.18; P < .001; HR, 3.08; 95% CI, 1.47-6.48; P = .003; and HR, 5.02; 95% CI, 1.47-17.12; P = .010; respectively).
  
  
  CONCLUSIONS
  Old TB lesion and gastrectomy were significant risk factors in the EGC cohort. In addition, old TB lesion and ≥ 15% postoperative reductions in weight and albumin level were significant risk factors in the gastrectomy subgroup.
authors: Center for Gastric Cancer, Research Institute for National Cancer Control and Evaluation, National Cancer Center, Goyang, Korea; Center for Gastric Cancer, Research Institute for National Cancer Control and Evaluation, National Cancer Center, Goyang, Korea; Department of Internal Medicine, and the Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, National Cancer Center, Goyang, Korea.
authors: Il Ju
authors: IJ
authors: Choi
authors: Center for Gastric Cancer, Research Institute for National Cancer Control and Evaluation, National Cancer Center, Goyang, Korea; Department of Internal Medicine, and the Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, National Cancer Center, Goyang, Korea.
authors: Young-Woo
authors: YW
authors: Kim
authors: Center for Gastric Cancer, Research Institute for National Cancer Control and Evaluation, National Cancer Center, Goyang, Korea; Respiratory Clinic and Division of Respiratory and Critical Care Medicine, Research Institute for National Cancer Control and Evaluation, National Cancer Center, Goyang, Korea. Electronic address: jekyde7@gmail.com.
authors: Hee Seok
authors: HS
authors: Lee
authors: Center for Gastric Cancer, Research Institute for National Cancer Control and Evaluation, National Cancer Center, Goyang, Korea.
authors: Keun Won
authors: KW
authors: Ryu
authors: Center for Gastric Cancer, Research Institute for National Cancer Control and Evaluation, National Cancer Center, Goyang, Korea.
authors: Hong Man
authors: HM
authors: Yoon
authors: Center for Gastric Cancer, Research Institute for National Cancer Control and Evaluation, National Cancer Center, Goyang, Korea.
authors: Bang Wool
authors: BW
authors: Eom
authors: Center for Gastric Cancer, Research Institute for National Cancer Control and Evaluation, National Cancer Center, Goyang, Korea.
authors: Chan Gyoo
authors: CG
authors: Kim
authors: Center for Gastric Cancer, Research Institute for National Cancer Control and Evaluation, National Cancer Center, Goyang, Korea.
authors: Jong Yeul
authors: JY
authors: Lee
authors: Center for Gastric Cancer, Research Institute for National Cancer Control and Evaluation, National Cancer Center, Goyang, Korea.
authors: Soo-Jeong
authors: SJ
authors: Cho
authors: Department of Internal Medicine, and the Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, National Cancer Center, Goyang, Korea.
authors: Byung-Ho
authors: BH
authors: Nam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000150:complications* / Q000601:surgery*; D014376:Tuberculosis / Q000453:epidemiology / Q000209:etiology*