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Helicobacter pylori infection is associated with favorable outcome in advanced gastric cancer patients treated with S‐1 adjuvant chemotherapy
Author(s) -
Nishizuka Satoshi S.,
Tamura Gen,
Nakatochi Masahiro,
Fukushima Norimasa,
Ohmori Yukimi,
Sumida Chihiro,
Iwaya Takeshi,
Takahashi Takashi,
Koeda Keisuke
Publication year - 2018
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24977
Subject(s) - medicine , helicobacter pylori , propensity score matching , hazard ratio , cancer , gastroenterology , chemotherapy , confidence interval , adjuvant , confounding , cohort , oncology , surgery
Background and Objectives Limited information exists regarding beneficial effects of Helicobacter pylori . To examine the effect in advanced gastric cancer, we compared survival for patients treated with surgery‐only or adjuvant chemotherapy on the basis of H. pylori infection status. Methods A cohort of 491 patients who underwent R0 resection for locally advanced gastric cancer between 2000 and 2009 at 12 institutions in northern Japan was included. H. pylori infection status, was assessed from paraffin‐embedded formalin‐fixed samples. Overall survival (OS) and disease‐free survival (DFS) in surgery‐only (Surgery) and adjuvant chemotherapy (S‐1) groups were analyzed. A propensity score matching was employed to correct for confounding factors by indication. Results H. pylori infection was positive in 175 patients and negative in 316 patients. H. pylori ‐positive patients showed significantly better survival than H. pylori ‐negative patients in both OS (hazard ratio [HR] 0.593, 95% confidence interval [CI] 0.417‐0.843; P = 0.003]) and DFS (HR 0.679, 95%CI 0.492‐0.937; P = 0.018). Propensity score matching further confirmed that S‐1 was virtually only effective when tumors were H. pylori ‐positive. Conclusions The favorable outcome of H. pylori ‐positive patients implies that the host immune system is modulated by H. pylori enhancing the chemotherapeutic efficacy.