Haim Shmuely1,2, Baruch Brenner3,4, David Groshar5,4, Nir Hadari6, Ofer Purim3,4, Meital Nidam5,4, Merab Eligalashvili5,4, Jacob Yahav1,2, Hanna Bernstine5,4. 1. Department of Internal Medicine D and Helicobacter Research Institute, Kaplan Medical Center, Rehovot, Israel. 2. Faculty of Medicine, Hebrew University, Jerusalem, Israel. 3. Institute of Oncology, Davidoff Cancer Center, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel. 4. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 5. Department of Nuclear Medicine, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel. 6. Dan District, Clalit Health Services, Or Yehuda, Israel.
Abstract
BACKGROUND: Evidence has been emerging that Helicobacter pylori may also impact colorectal cancer (CRC). Positron emission tomography/computed tomography (PET/CT) imaging can predict overall survival in CRC patients. OBJECTIVES: To determine a possible association between H. pylori seropositivity and all-cause mortality among CRC patients evaluated by PET/CT scans. METHODS: This prospective cohort study was comprised of 110 consecutive CRC patients who had undergone a PET/CT evaluation in a tertiary academic medical center. Data included demographics, body mass index (BMI), tumor node metastasis stage at diagnosis, treatment, time from diagnosis to PET/CT, and PET/CT findings. All patients were tested for anti-H. pylori immunoglobulin G (IgG) antibodies and followed for 36 months from the day of the PET/CT scan. Mortality was documented. Univariate and multivariate Cox regression was used to estimate the hazard ratio (HR) of H. pylori serological status. RESULTS: During the follow-up period, of the 110 CRC patients 41 (37.3%) died and 69 (62.7%) survived. Of the 41 patients, 26 (63.4%) were H. pylori seropositive and 15 (36.6%) were seronegative. Multivariate analysis showed that H. pylori seropositivity was associated with increased mortality (HR 3.46, 95% confidence interval 1.63-7.32), stage IV at diagnosis, metastatic disease found on PET/CT, longer time from diagnosis to PET/CT, lower BMI, and older age. CONCLUSIONS: Our findings suggest that H. pylori infection may be a risk factor for all-cause mortality among CRC patients who are evaluated by PET/CT. Multicenter studies with larger patient groups are needed to confirm our findings.
BACKGROUND: Evidence has been emerging that Helicobacter pylori may also impact colorectal cancer (CRC). Positron emission tomography/computed tomography (PET/CT) imaging can predict overall survival in CRCpatients. OBJECTIVES: To determine a possible association between H. pylori seropositivity and all-cause mortality among CRCpatients evaluated by PET/CT scans. METHODS: This prospective cohort study was comprised of 110 consecutive CRCpatients who had undergone a PET/CT evaluation in a tertiary academic medical center. Data included demographics, body mass index (BMI), tumor node metastasis stage at diagnosis, treatment, time from diagnosis to PET/CT, and PET/CT findings. All patients were tested for anti-H. pylori immunoglobulin G (IgG) antibodies and followed for 36 months from the day of the PET/CT scan. Mortality was documented. Univariate and multivariate Cox regression was used to estimate the hazard ratio (HR) of H. pylori serological status. RESULTS: During the follow-up period, of the 110 CRCpatients 41 (37.3%) died and 69 (62.7%) survived. Of the 41 patients, 26 (63.4%) were H. pylori seropositive and 15 (36.6%) were seronegative. Multivariate analysis showed that H. pylori seropositivity was associated with increased mortality (HR 3.46, 95% confidence interval 1.63-7.32), stage IV at diagnosis, metastatic disease found on PET/CT, longer time from diagnosis to PET/CT, lower BMI, and older age. CONCLUSIONS: Our findings suggest that H. pyloriinfection may be a risk factor for all-cause mortality among CRCpatients who are evaluated by PET/CT. Multicenter studies with larger patient groups are needed to confirm our findings.