Gastritis staging in the endoscopic follow-up for the secondary prevention of gastric cancer: a 5-year prospective study of 1755 patients

Rugge, Massimo; Meggio, Alberto; Pravadelli, Cecilia; Barbareschi, Mattia; Fassan, Matteo; Gentilini, Maria; Zorzi, Manuel; Pretis, G. De; Graham, David Y.; Genta, Robert M.

doi:10.1136/gutjnl-2017-314600

Cited by 148 publications

(122 citation statements)

References 47 publications

Supporting

Mentioning

104

Contrasting

Unclassified

Order By: Relevance

“…Operative link on gastritis assessment (OLGA) staging estimates the risk for GC in progressive stages (0‐IV). In a prospective study performed on a cohort of 1755 consecutive dyspeptic patients with a median follow‐up of 55 months, Rugge et al confirmed that OLGA gastritis staging is reliable in predicting the risk for gastric epithelial neoplasia development. After initial endoscopy with mapped gastric biopsies, OLGA staging, and assessment of H. pylori infection, patients with stages II III and IV underwent a second endoscopy with restaging, whereas those with stages 0 and I were followed clinically.…”

Section: Gastric Cancer: Prevention Strategies/screening For Preneoplmentioning

confidence: 97%

Gastric cancer: epidemiology, prevention, and therapy

et al. 2018

View full text Add to dashboard Cite

Gastric cancer (GC) is still the third leading cause of cancer death in both sexes worldwide. Helicobacter pylori infection is the most important risk factor for GC and, in spite of the consistent trend of a decreasing incidence, in 2015 approximately 4.4 billion individuals-more than half the world's population-were infected with H. pylori. The birth cohort pattern of decreased H. pylori infection reported in a systematic review contributes to explain the declining GC mortality in Japan. Current trends in estimated annual percentage change of GC incidence foreshadow expected reversals in both falling incidence and male predominance among US non-Hispanic whites. Combining serum pepsinogen 1 and H. pylori serology was shown to be useful for GC risk stratification in a Finnish population. Gastritis staging by operative link on gastritis assessment was confirmed to be reliable in predicting GC risk in a large prospective study. In a randomized trial from South Korea, H. pylori eradication therapy significantly reduced the rates of metachronous GC in patients who received curative endoscopic resection for early GC. A study based on a territory-wide health care database of the Hong Kong Hospital Authority showed that aspirin use is associated with a reduced GC risk. Another study based on the same database showed that proton pump inhibitors increase GC risk, but methodological biases have most likely acted as confounders. Confirmatory data on the role of endoscopic submucosal dissection in patients with early GC have been published. The phase III FLOT4 trial has shown that the FLOT triplet regimen (docetaxel, oxaliplatin, leucovorin, and 5-fluorouracil) improves the outcome of patients with GC and locoregional disease as compared to the ECF triplet (epirubicin, cisplatin, and 5-fluorouracil). In the phase III ATTRACTION-2 trial, nivolumab was shown to be an effective treatment option with a relative safe profile for heavily pretreated patients with advanced GC.

show abstract

Section: Gastric Cancer: Prevention Strategies/screening For Preneoplmentioning

confidence: 97%

Gastric cancer: epidemiology, prevention, and therapy

et al. 2018

View full text Add to dashboard Cite

show abstract

“…7,8 Several studies show a diminished risk of GC with low OLGA stages (0, I, II) and high risk of GC with high OLGA stages (III, IV). [9][10][11][12] Recently, the operative link on gastric intestinal metaplasia assessment (OLGIM) staging system, which replaces the atrophy score with IM score, was proposed and is associated with a high inter-observer agreement. 13 However, OLGA or OLGIM systems require biopsy and they need to be validated whether these invasive systems are effective enough to estimate the risk of GC not only for the intestinal type but also for the diffuse type.…”

mentioning

confidence: 99%

Usefulness of OLGA and OLGIM system not only for intestinal type but also for diffuse type of gastric cancer, and no interaction among the gastric cancer risk factors

et al. 2018

View full text Add to dashboard Cite

Background The operative link on gastric atrophy (OLGA) and operative link on gastric intestinal metaplasia (OLGIM) stages have been suggested for risk estimation of gastric cancer (GC). However, usefulness of OLGA/OLGIM systems in diffuse type of GC was not investigated so far. The aims of this study were to evaluate the OLGA/OLGIM systems in estimating the GC risk according to Lauren's classification and to investigate the interaction among the risk factors. Materials and methods The OLGA/OLGIM stages were evaluated in 1398 (765 control and 633 GC patients) who were prospectively enrolled in the Seoul National University Bundang Hospital. Synergistic interaction among the risk factors for GC was calculated using an additive model. Results Among 387 intestinal‐type GC patients, 71 (18.3%) were high‐risk OLGA stages (III, IV) and 113 (29.2%) were high‐risk OLGIM stages (III, IV). Of the 246 patients with diffuse‐type GC, 36 (14.6%) were high‐risk OLGA stages and 39 (15.9%) were high‐risk OLGIM stages. Multivariable analysis revealed family history of GC, Helicobacter pylori infection, high‐risk OLGA stages, and high‐risk OLGIM stages as independent risk factors for GC regardless of histologic type (odds ratios [ORs] 1.78, 1.94, 2.63, and 3.18, respectively). There was no significant risk modification among the H. pylori infection, family history of GC, and high‐risk OLGA/OLGIM stages. Conclusion High‐risk OLGA/OLGIM stages are important prediction markers for GC regardless of H. pylori infection or family history of GC not only for the intestinal type but also for diffuse‐type GC.

show abstract

“…Furthermore, 53% of stage II cases did not change, 19% progressed to stage III, and only 28% returned to stage 0 or I. 32 These recent reports show that even in patients with gastritis in treatment-responsive stages, the recovery time is long, and there are certainly cases that still progress to gastric cancer even after H pylori eradication.…”

Section: Logical Lead Time From the Eradication Of H Pylori To A Rementioning

confidence: 91%

Prevention of gastric cancer by Helicobacter pylori eradication: A review from Japan

Uno¹

2019

Cancer Medicine

View full text Add to dashboard Cite

Japan introduced a Helicobacter pylori eradication therapy strategy in 2013, with the aim of decreasing the number of gastric cancer‐related death, the number of new cases of gastric cancer, and associated medical costs. Five years have passed since then, but no reduction in the annual number of gastric cancer has been observed. In addition, it was suggested that the number of deaths due to gastric cancer could be reduced to 30,000 a year by 2020, but the annual death toll in 2017 remained at more than 45,000. Based on the above evidence, it was examined whether it was possible to reach the target value based on the data from the last 5 years. The number of deaths per year in 2020 is predicted to be more than 40,000, which is clearly different from the target value. Logically, the effect of the strategy might appear by 2023. However, there is a possibility that the risk of gastric cancer may increase in some populations due to the influence of proton pump inhibitors and dysbiosis in the gastric microbiome. To solve these problems, combined therapy with PPIs and aspirin for patients after H pylori eradication should be considered.

show abstract

Gastritis staging in the endoscopic follow-up for the secondary prevention of gastric cancer: a 5-year prospective study of 1755 patients

Cited by 148 publications

References 47 publications

Gastric cancer: epidemiology, prevention, and therapy

Gastric cancer: epidemiology, prevention, and therapy

Usefulness of OLGA and OLGIM system not only for intestinal type but also for diffuse type of gastric cancer, and no interaction among the gastric cancer risk factors

Prevention of gastric cancer by Helicobacter pylori eradication: A review from Japan

Contact Info

Product

Resources

About