期刊
DIGESTION
卷 102, 期 2, 页码 236-245出版社
KARGER
DOI: 10.1159/000504132
关键词
Helicobacter pylori; Stomach neoplasms; Second primary; Endoscopic submucosal resection; Propensity score
This study showed that successful eradication of H. pylori can prevent metachronous gastric cancer after endoscopic submucosal dissection for early gastric cancer. Persistent H. pylori infection may increase the risk of metachronous gastric cancer.
Background and Aim: Helicobacter pylori is the leading cause of gastric cancer, but it is still uncertain whether eradicating H. pylori in early gastric cancer (EGC) patients who underwent endoscopic resection can prevent metachronous gastric cancer (MGC). This study aimed to investigate the effect of H. pylori eradication to prevent MGC after endoscopic submucosal dissection (ESD). Methods: In this propensity-matched retrospective observational study, 770 patients with EGC who received ESD were enrolled. The outcome was the incidence of MGC; this was compared between the persistent and eradicated groups. Results: MGC was detected in 27 patients (7.8%) during a median period of 39.0 months (range 26.0-64.0). After propensity matching, 126 pairs of patients in each group were analyzed. The 5-year cumulative incidence rates of MGC were 13.2 and 3.9% in the persistent and eradicated groups, respectively (p= 0.021, log-rank test). On multivariate analysis, H. pylori eradication prevented MGC significantly (hazard ratio [HR] 0.32; p = 0.029). The results remained robust after inverse probability of treatment weighting analysis (HR 0.30; p = 0.020). Conclusions: Successful H. pylori eradication could prevent MGC after ESD for EGC.
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