Helicobacter pylori eradication prevents secondary gastric cancer in patients with mild-to-moderate atrophic gastritis

Minoru Kato, Yoshito Hayashi, Tsutomu Nishida, Masahide Oshita, Fumihiko Nakanishi, Shinjiro Yamaguchi, Shinji Kitamura, Akihiro Nishihara, Tomofumi Akasaka, Hideharu Ogiyama, Masanori Nakahara, Takuya Yamada, Osamu Kishida, Masashi Yamamoto, Akinori Shimayoshi, Yoshiki Tsujii, Motohiko Kato, Shinichiro Shinzaki, Hideki Iijima, Tetsuo Takehara

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Background and Aim: Whether Helicobacter pylori eradication prevents metachronous recurrence after endoscopic resection (ER) of early gastric cancer remains controversial. This multicenter retrospective study aimed to evaluate the long-term (> 5 years) effects of H. pylori eradication by stratifying patients' baseline degrees of atrophic gastritis. Methods: A total of 483 H. pylori-positive patients who had undergone ER for early gastric cancer were divided into two groups—(i) those having undergone successful H. pylori eradication within 1 year after ER (eradicated group, n = 294) and (ii) those with failed or not attempted H. pylori eradication (non-eradicated group, n = 189). The cumulative incidences of metachronous gastric cancer between the two groups were compared for all patients, for patients with mild-to-moderate atrophic gastritis (n = 182), and for patients with severe atrophic gastritis (n = 301). Results: During a median follow-up of 5.2 years (range 1.1–14.8), metachronous cancer developed in 52 (17.7%) patients in the eradicated group and in 35 (18.5%) patients in the non-eradicated group (P = 0.11, log–rank test). In patients with mild-to-moderate atrophic gastritis (111 and 71 in the eradicated and non-eradicated groups, respectively), the cumulative incidence of metachronous cancer was significantly lower in the eradicated group than that in the non-eradicated group (P = 0.03, log–rank test). However, no significant intergroup difference was observed in patients with severe atrophic gastritis (P = 0.69, log–rank test). Conclusions: Helicobacter pylori eradication had a preventive effect on the development of metachronous gastric cancer in patients with mild-to-moderate atrophic gastritis.

Original languageEnglish
Pages (from-to)2083-2090
Number of pages8
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume36
Issue number8
DOIs
Publication statusPublished - 2021 Aug

Keywords

  • Helicobacter pylori
  • atrophic gastritis
  • endoscopic resection
  • gastric cancer
  • metachronous cancer

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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