Y H Kwon1, J Heo, H S Lee, C M Cho, S W Jeon. 1. Division of Gastroenterology, Department of Internal Medicine, Kyungpook National University Medical Center, Daegu, South Korea.
Abstract
BACKGROUND: Whether 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). AIM: To compare the incidence of metachronous gastric lesion in the eradicated group and the persistent group. Second end point is to evaluate the risk factors for metachronous gastric lesions after ESD for EGC. METHODS: In a single centre, between May 2007 and May 2010, the patients who had evidence of H. pylori infection at the time of ESD for EGC were included, and the follow-up data were analysed retrospectively. RESULTS: We enrolled 283 patients who have shown H. pylori infection at the time of ESD for EGC. Successful eradication was achieved for 214 patients (75.6%) (Eradicated group), and 69 patients (24.4%) showed persistent H. pylori infection (Persistent group). Metachronous gastric lesions developed in 13 (18.8%) in the persistent group and 18 (8.4%) in the eradicated group (P = 0.016). In the ≥60-year-old group, the cumulative incidence of metachronous gastric cancer showed a significant increase (P = 0.012). Cumulative hazard ratio of subsequent gastric metachronous lesions differed between the eradication group and the persistent infection group (OR = 2.322, 95% CI = 1.136-4.744, P = 0.021), and ≥60 age at the time of endoscopic resection (OR = 2.803, 95% CI = 1.207-6.509, P = 0.016). CONCLUSIONS: Both persistent H. pylori infection and old age (≥60) are independent risk factors for the increased incidence of metachronous gastric cancer.
BACKGROUND: Whether 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). AIM: To compare the incidence of metachronous gastric lesion in the eradicated group and the persistent group. Second end point is to evaluate the risk factors for metachronous gastric lesions after ESD for EGC. METHODS: In a single centre, between May 2007 and May 2010, the patients who had evidence of H. pylori infection at the time of ESD for EGC were included, and the follow-up data were analysed retrospectively. RESULTS: We enrolled 283 patients who have shown H. pylori infection at the time of ESD for EGC. Successful eradication was achieved for 214 patients (75.6%) (Eradicated group), and 69 patients (24.4%) showed persistent H. pylori infection (Persistent group). Metachronous gastric lesions developed in 13 (18.8%) in the persistent group and 18 (8.4%) in the eradicated group (P = 0.016). In the ≥60-year-old group, the cumulative incidence of metachronous gastric cancer showed a significant increase (P = 0.012). Cumulative hazard ratio of subsequent gastric metachronous lesions differed between the eradication group and the persistent infection group (OR = 2.322, 95% CI = 1.136-4.744, P = 0.021), and ≥60 age at the time of endoscopic resection (OR = 2.803, 95% CI = 1.207-6.509, P = 0.016). CONCLUSIONS: Both persistent H. pylori infection and old age (≥60) are independent risk factors for the increased incidence of metachronous gastric cancer.
Authors: Yong Hwan Kwon; Nayoung Kim; Ju Yup Lee; Yoon Jin Choi; Kichul Yoon; Hyuk Yoon; Cheol Min Shin; Young Soo Park; Dong Ho Lee Journal: J Cancer Prev Date: 2014-12
Authors: Da Hyun Jung; Jie-Hyun Kim; Hyun Soo Chung; Jun Chul Park; Sung Kwan Shin; Sang Kil Lee; Yong Chan Lee Journal: PLoS One Date: 2015-04-27 Impact factor: 3.240