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Helicobacter pylori eradication prevents secondary gastric cancer in patients with mild‐to‐moderate atrophic gastritis
Author(s) -
Kato Minoru,
Hayashi Yoshito,
Nishida Tsutomu,
Oshita Masahide,
Nakanishi Fumihiko,
Yamaguchi Shinjiro,
Kitamura Shinji,
Nishihara Akihiro,
Akasaka Tomofumi,
Ogiyama Hideharu,
Nakahara Masanori,
Yamada Takuya,
Kishida Osamu,
Yamamoto Masashi,
Shimayoshi Akinori,
Tsujii Yoshiki,
Kato Motohiko,
Shinzaki Shinichiro,
Iijima Hideki,
Takehara Tetsuo
Publication year - 2021
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.15396
Subject(s) - helicobacter pylori , medicine , atrophic gastritis , gastroenterology , cancer , gastritis , cumulative incidence , incidence (geometry) , log rank test , retrospective cohort study , survival analysis , cohort , physics , optics
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.