Preventing Metachronous Gastric Cancer after the Endoscopic Resection of Gastric Epithelial Neoplasia: Roles of &lt;i&gt;Helicobacter pylori&lt;/i&gt; Eradication and Aspirin

Watari, Jiro; Tomita, Toshihiko; Tozawa, Katsuyuki; Oshima, Tadayuki; Fukui, Hirokazu; Miwa, Hiroto

doi:10.5009/gnl19079

Cited by 11 publications

(7 citation statements)

References 92 publications

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“…In contrast with previous studies [ 18 , 19 , 20 ], the associations of statin, aspirin, and COX2 inhibitor use with a decreased risk of metachronous gastric cancer did not reach statistical significance in this study. We suggest two reasons for this discrepancy.…”

Section: Discussioncontrasting

confidence: 99%

Use of Antibiotics and Probiotics Reduces the Risk of Metachronous Gastric Cancer after Endoscopic Resection

Arai

Niikura

Hayakawa

et al. 2021

Biology

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Metachronous gastric cancer often occurs after endoscopic resection. Appropriate management, including chemoprevention, is required after the procedure. This study was performed to evaluate the association between medication use and the incidence of metachronous gastric cancer after endoscopic resection. This multicenter retrospective cohort study was conducted with data from nine hospital databases on patients who underwent endoscopic resection for gastric cancer between 2014 and 2019. The primary outcome was the incidence of metachronous gastric cancer. We evaluated the associations of metachronous gastric cancer occurrence with medication use and clinical factors. Hazard ratios were adjusted by age and Charlson comorbidity index scores, with and without consideration of sex, smoking status, and receipt of Helicobacter pylori eradication therapy during the study period. During a mean follow-up period of 2.55 years, 10.39% (140/1347) of all patients developed metachronous gastric cancer. The use of antibiotics other than those used for H. pylori eradication was associated with a lower incidence of metachronous gastric cancer than was non-use (adjusted hazard ratio (aHR) 0.56, 95% confidence interval (CI) 0.38–0.85, p = 0.006). Probiotic drug use was also associated with a lower incidence of metachronous gastric cancer compared with non-use (aHR 0.29, 95% CI 0.091–0.91, p = 0.034). In conclusion, the use of antibiotics and probiotic drugs was associated with a decreased risk of metachronous gastric cancer. These findings suggest that the gut microbiome is associated with metachronous gastric cancer development.

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Section: Discussioncontrasting

confidence: 99%

Use of Antibiotics and Probiotics Reduces the Risk of Metachronous Gastric Cancer after Endoscopic Resection

Arai

Niikura

Hayakawa

et al. 2021

Biology

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“…For example, Ihara et al found that the incidence of intestinal-type gastric cancer was higher in aspirin users than in non-users (0.14%; p = 0.004) [ 18 ]. The molecular basis of the effects of H. pylori eradication and aspirin use on the risk of MGC have also been explored [ 15 ]. In another meta-analysis, aspirin use was associated with a reduced incidence of several cancers (odds ratio 0.62; 95% CI, 0.55–0.70; p < 0.0001).…”

Section: Discussionmentioning

confidence: 99%

“…In the case of H. pylori infection, which has a proven protective effect on metachronous recurrence, it is necessary to change the molecule and find the point of no return for infected chronic atrophic gastritis and intestinal metaplasia, compared to a single treatment. It has been suggested that aspirin and nonsteroidal anti-inflammatory drugs have additional effects [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Aspirin Use Is Not Associated with the Risk of Metachronous Gastric Cancer in Patients without Helicobacter pylori Infection

Kim

Lee

et al. 2021

JCM

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Introduction: Helicobacter pylori (H. pylori) eradication can prevent metachronous gastric cancer (MGC) after the performance of an endoscopic resection for early gastric cancer (EGC). However, 50% of infections persist after eradication, and the identification of MGC protective factors is important. The anti-tumor activity of aspirin has been demonstrated, but its efficacy in preventing MGC remains controversial. We evaluated the effect of aspirin on metachronous recurrence in H. pylori-negative patients. Methods: A total of 4351 patients were evaluated between January 2007 and December 2016, and 2151 patients who met the inclusion criteria were analyzed. The primary outcome was the cumulative incidence of MGC after an endoscopic resection for EGC. Results: During a 5-year median follow-up (interquartile range, 3.5–6.2), MGC developed in 176 (7.7%) patients, with a cumulative incidence of 89.4% in aspirin users and 92.7% in non-users; this difference was not statistically significant (p = 0.64). The duration of aspirin uses and the occurrence of MGC in both groups were not significantly different. There was no significant difference between groups when the duration of aspirin use was categorized into ≤1 year (hazard ratio (HR), 0.64; 0.20–2.01, p = 0.45), 1–4 years (HR, 1.35; 0.66–2.76, p = 0.41), and >4 years (HR, 1.17; 0.67–2.03, p = 0.58). Conclusions: Aspirin use was not associated with a lower risk of MGC in H. pylori-negative patients. Further prospective studies are needed.

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“…According to the published clinical studies, Hp eradication and aspirin use are likely to stop the development of metachronous gastric cancer (MGC). Meta-analyses and RCTs show that Hp eradication reduces the risk of MGC development in patients who were followed up for a long term after the eradication (≥5 years) [ 119 ].…”

Section: Prevention Of Gastric Cancermentioning

confidence: 99%

Association of Helicobacter pylori Infection and Host Cytokine Gene Polymorphism with Gastric Cancer

Zeyaullah

AlShahrani

Ahmad

2021

Canadian Journal of Gastroenterology and Hepatology

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The global cancer burden of new cases of various types rose with millions of death in 2018. Based on the data extracted by GLOBOCAN 2018, gastric cancer (GC) is the third leading cause of mortality related to cancer across the globe. Carcinogenic or oncogenic infections associated with Helicobacter pylori (Hp) are regarded as one of the essential risk factors for GC development. It contributes to the increased production of cytokines that cause inflammation prior to their growth in the host cells. Hp infections and specific types of polymorphisms within the host cells encoding cytokines are significant contributors to the hostʼs increased susceptibility in terms of the development of GC. Against the backdrop of such an observation is that only a small portion of the cells infected can become malignant. The diversities are a consequence of the differences in the pathogenic pathway of the Hp, susceptibility of the host, environmental conditions, and interplay between these factors. It is evident that hosts carrying cytokine genes with high inflammatory levels and polymorphism tend to exhibit an increased risk of development of GC, with special emphasis being placed on the host cytokines gene polymorphisms.

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Preventing Metachronous Gastric Cancer after the Endoscopic Resection of Gastric Epithelial Neoplasia: Roles of <i>Helicobacter pylori</i> Eradication and Aspirin

Cited by 11 publications

References 92 publications

Use of Antibiotics and Probiotics Reduces the Risk of Metachronous Gastric Cancer after Endoscopic Resection

Use of Antibiotics and Probiotics Reduces the Risk of Metachronous Gastric Cancer after Endoscopic Resection

Aspirin Use Is Not Associated with the Risk of Metachronous Gastric Cancer in Patients without Helicobacter pylori Infection

Association of Helicobacter pylori Infection and Host Cytokine Gene Polymorphism with Gastric Cancer

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