title: Characteristics of Primary and Metachronous Gastric Cancers Discovered afterHelicobacter pyloriEradication: A Multicenter Propensity Score-Matched Study.
abstract: OBJECTIVE
  Gastric cancers develop even after successfulHelicobacter pylorieradication. We aimed to clarify the characteristics of early gastric cancers discovered afterH. pylorieradication.
  
  
  METHODS
  A total of 1,053 patients with early gastric cancer treated by endoscopic submucosal dissection were included. After matching the propensity score, we retrospectively investigated the clinicopathological features of 192 patients, including 96 patients who had undergone successfulH. pylorieradication (Hp-eradicated group) and 96 patients who had activeH. pyloriinfection (Hp-positive group).
  
  
  RESULTS
  In theHp-eradicated group, early gastric cancers were discovered 1 to 15 years (median, 4.1 years) afterH. pylorieradication. Compared withHp-positive patients,Hp-eradicated patients showed a more frequently depressed configuration (81% vs 53%, respectively, p<0.0001) and a higher trend toward submucosal invasion (18% vs 8%, respectively, p=0.051). A multivariable analysis revealed the macroscopic depressed type to be characteristics of early gastric cancers afterH. pylorieradication. Among patients in theHp-eradicated group, metachronous cancers showed less frequent depressed lesions (68% vs 84%, respectively, p=0.049) and smaller tumor sizes (median, 11 mm vs 14 mm, respectively, p=0.014) than primary cancers.
  
  
  CONCLUSIONS
  Early gastric cancers afterH. pylorieradication are characterized by a depressed configuration. Careful follow-up endoscopies are necessary afterH. pylorieradication.
authors.affiliation: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Maehata
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Morioka, Japan.
authors.forename: Shotaro
authors.initials: S
authors.lastname: Nakamura
authors.affiliation: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Motohiro
authors.initials: M
authors.lastname: Esaki
authors.affiliation: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Fumie
authors.initials: F
authors.lastname: Ikeda
authors.affiliation: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Moriyama
authors.affiliation: Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Risa
authors.initials: R
authors.lastname: Hida
authors.affiliation: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Ema
authors.initials: E
authors.lastname: Washio
authors.affiliation: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Umeno
authors.affiliation: Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Minako
authors.initials: M
authors.lastname: Hirahashi
authors.affiliation: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Takanari
authors.initials: T
authors.lastname: Kitazono
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Morioka, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Matsumoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology*; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016609:Neoplasms, Second Primary / Q000382:microbiology / Q000473:pathology*; D057216:Propensity Score; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000382:microbiology / Q000473:pathology*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Depressed configuration; Early gastric cancer; Endoscopic submucosal dissection; Helicobacter pylori eradication; Metachronous gastric cancer