Failure of <i><scp>H</scp>elicobacter pylori</i> eradication and age are independent risk factors for recurrent neoplasia after endoscopic resection of early gastric cancer in 283 patients

Kwon, Yong Hwan; Heo, Jun; Lee, Hyun Seok; Cho, C. M.; Jeon, Seong Woo

doi:10.1111/apt.12633

Cited by 60 publications

(63 citation statements)

References 34 publications

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“…In this regard, a prospective validation study would be mandatory in the future. Third, the metachronous cancer incidence rate was slightly high compared with that in past reports . This may be attributable to the high frequency of severe atrophy in our subjects.…”

Section: Discussioncontrasting

confidence: 58%

“…Aging has been reported to be associated with both occurrence of primary gastric cancer and metachronous recurrence, possibly because a long duration of HP infection is required for the development of gastric cancer. However, this factor was not significant in our study, probably as a result of the relatively older ages of our subjects compared to patients in studies showing age as a significant factor . Older age appears to be naturally correlated with high frequencies of severe atrophy and IM in our patients.…”

Section: Discussionmentioning

confidence: 99%

“…Although ER offers the strong advantage of being less invasive than surgery, it carries an inevitable risk of the development of metachronous gastric cancer. Several studies have found that successful HP eradication decreased metachronous gastric cancer after ER, [9][10][11][12][13][14] whereas others have shown no beneficial effect of HP eradication in reducing the risk of metachronous lesions. 15,16 In this regard, two prospective randomized controlled trials have yielded contradictory results.…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic features associated with development of metachronous gastric cancer in patients who underwent endoscopic resection followed by Helicobacter pylori eradication

Moribata

Kato

Iguchi

et al. 2015

Digestive Endoscopy

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Section: Discussioncontrasting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Endoscopic features associated with development of metachronous gastric cancer in patients who underwent endoscopic resection followed by Helicobacter pylori eradication

Moribata

Kato

Iguchi

et al. 2015

Digestive Endoscopy

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“…Unlike surgery of EGC, ER preserves most part of the stomach and this leads to increased risk of metachronous gastric cancer (MGC) development in residual gastric mucosa[5]. As more EGCs are treated with ER recently, identifying risk factors of MGC development after ER of EGC is important.…”

Section: Introductionmentioning

confidence: 99%

“…A study of 132 patients who underwent ER for EGC and showed positive H. pylori serologic test demonstrated that H. pylori eradication inhibited the growth of new gastric cancer[13] and a retrospective study of 283 patients with H. pylori infection at time of ESD for EGC showed that failure of H. pylori eradication was a risk factor of MGC development[5]. However, a study of 1258 patients who underwent ESD for EGC reported that the incidence rate of MGC was not significantly different between patients with or without H. pylori eradication[14] and a retrospective study of 268 patients with a 5-year follow-up reported that H. pylori eradication after ER for EGC did not significantly reduced the incidence of MGC[15].…”

Section: Introductionmentioning

confidence: 99%

Association betweenHelicobacter pyloristatus and metachronous gastric cancer after endoscopic resection

Kim¹,

Lee²,

Bae³

et al. 2016

WJG

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AIMTo investigate the effect of Helicobacter pylori (H. pylori) status test and H. pylori eradication on the occurrence of metachronous gastric cancer (MGC) after endoscopic submucosal dissection (ESD) of early gastric cancer (EGC) and risk factors of MGC.METHODSThe authors retrospectively reviewed the medical records of 433 patients (441 lesions) who underwent ESD for EGC from January 2005 to January 2015 in Yeungnam University Hospital. Patients were categorized into two groups; the H. pylori tested group (n = 257) and the H. pylori non-tested group (n = 176) based on performance of H. pylori status test after ESD of EGC. The H. pylori tested group was further categorized into three subgroups based on H. pylori status; the H. pylori-eradicated subgroup (n = 120), the H. pylori-persistent subgroup (n = 42), and the H. pylori-negative subgroup (n = 95). Incidences of MGC and risk factors of MGC were identified.RESULTSMedian follow-up duration after ESD was 30.00 mo (range, 6-107 mo). Total 15 patients developed MGC during follow-up. MGC developed in 11 patients of the H. pylori tested group (7 in the H. pylori-negative subgroup, 3 in the H. pylori-eradicated subgroup, and 1 in the H. pylori-persistent subgroup) and 4 patients of the H. pylori non-tested group (P > 0.05). The risk factors of MGC were endoscopic mucosal atrophy in the H. pylori tested group and intestinal metaplasia in all patients.CONCLUSIONH. pylori eradication and H. pylori status test seems to have no preventive effect on the development of MGC after ESD for EGC. The risk factors of MGC development were endoscopic mucosal atrophy in the H. pylori tested group alone and intestinal metaplasia in all patients.

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Serum pepsinogen levels can quantify the risk of development of metachronous gastric cancer after endoscopic resection

Iguchi

Kato

Yoshida

et al. 2016

Intl Journal of Cancer

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We have previously reported that serum pepsinogen (PG) can quantify the level of gastric mucosal atrophy, and that H. pylori eradication reduces cancer development in subjects with mild atrophy identified by serum PG levels. The aim of this study was to elucidate the predictive ability of serum PG levels for the development of metachronous gastric cancer (MGC) after endoscopic resection (ER) of primary cancer in association with H. pylori eradication. A retrospective chart review was performed, and 330 patients who underwent ER for initial early gastric cancer were enrolled. Presence or absence of H. pylori, serum PG levels, and endoscopic atrophy at ER were evaluated. H. pylori eradication was performed at the patient's request after ER. The incidence of MGC in these patients was analyzed. Of 330 patients, 47 developed MGC. Endoscopic extensive atrophy was observed more frequently in patients with MGC (p 5 0.001). Although PG I or PG II alone did not significantly differ according to development of MGC, the proportion of PG I/II 3.0, which is one of the criteria of PG test-positive, was significantly higher in patients with MGC (83 vs. 69%, p 5 0.04). H. pylori eradication after ER did not affect MGC development (p 5 0.2). On multivariate analysis, serum PG I/II ratio 3.3 was significantly associated with the development of MGC (hazard ratio: 3.66, 95% confidence interval: 1.47-12.25, p 5 0.004). The risk of MGC after ER could be quantitatively predicted by the PG I/II ratio regardless of H. pylori status.The International Agency for Research on Cancer (IARC) GLOBOCAN indicated that an estimated 1 million new cases of gastric cancer occurred worldwide in 2012, and it was the third most common cause of cancer death, accounting for 723,000 deaths. 1,2 In Japan, gastric cancer is the second most common cause of cancer death, accounting for 49,000 deaths per year.Accompanied by improvements in and increased use of endoscopy, detection of early stage gastric cancer has become more frequent. With improvement in endoscopic resection (ER) technique, represented by endoscopic submucosal dissection (ESD), ER has been widely accepted for local tumor resection. One of the merits of ER is that it can preserve the entire stomach. However, the procedure inevitably leaves stomach encompassing atrophic gastric mucosa, which is considered to be a hazardous region for cancer development. Hence, follow-up endoscopy for detecting metachronous gastric cancer (MGC) after ER is important.H. pylori infection causes chronic gastritis, which results in gastric atrophy, intestinal metaplasia, dysplasia and cancer. [3][4][5] In 1994, the IARC categorized H. pylori as a Group 1 carcinogen for gastric cancer. Recently, several meta-analyses reported the preventive effect of H. pylori eradication on gastric cancer development, [6][7][8][9] and the effect appears to be influenced by the background gastric mucosal status to some extent. Chen et al. reported that H. pylori eradication reduced the risk of gastric cancer in patients with non-atrop...

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Failure of Helicobacter pylori eradication and age are independent risk factors for recurrent neoplasia after endoscopic resection of early gastric cancer in 283 patients

Abstract: SUMMARY BackgroundWhether the incidence of metachronous gastric dysplasia and cancer could be decreased by eradication of Helicobacter pylori after endoscopic submucosal dissection (ESD) for early gastric cancer (EGC).

Cited by 60 publications

References 34 publications

Endoscopic features associated with development of metachronous gastric cancer in patients who underwent endoscopic resection followed by Helicobacter pylori eradication

Endoscopic features associated with development of metachronous gastric cancer in patients who underwent endoscopic resection followed by Helicobacter pylori eradication

Association betweenHelicobacter pyloristatus and metachronous gastric cancer after endoscopic resection

Serum pepsinogen levels can quantify the risk of development of metachronous gastric cancer after endoscopic resection

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