Characteristics of Primary and Metachronous Gastric Cancers Discovered after Helicobacter pylori Eradication: A Multicenter Propensity Score-Matched Study.
- Author:
Yuji MAEHATA
1
;
Shotaro NAKAMURA
;
Motohiro ESAKI
;
Fumie IKEDA
;
Tomohiko MORIYAMA
;
Risa HIDA
;
Ema WASHIO
;
Junji UMENO
;
Minako HIRAHASHI
;
Takanari KITAZONO
;
Takayuki MATSUMOTO
Author Information
- Publication Type:Multicenter Study ; Original Article
- Keywords: Helicobacter pylori eradication; Early gastric cancer; Endoscopic submucosal dissection; Metachronous gastric cancer; Depressed configuration
- MeSH: Follow-Up Studies; Helicobacter pylori*; Helicobacter*; Humans; Propensity Score; Retrospective Studies; Stomach Neoplasms*
- From:Gut and Liver 2017;11(5):628-634
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Gastric cancers develop even after successful Helicobacter pylori eradication. We aimed to clarify the characteristics of early gastric cancers discovered after H. pylori eradication. METHODS: A total of 1,053 patients with early gastric cancer treated by endoscopic submucosal dissection were included. After matching the propensity score, we retrospectively investigated the clinicopathological features of 192 patients, including 96 patients who had undergone successful H. pylori eradication (Hp-eradicated group) and 96 patients who had active H. pylori infection (Hp-positive group). RESULTS: In the Hp-eradicated group, early gastric cancers were discovered 1 to 15 years (median, 4.1 years) after H. pylori eradication. Compared with Hp-positive patients, Hp-eradicated patients showed a more frequently depressed configuration (81% vs 53%, respectively, p<0.0001) and a higher trend toward submucosal invasion (18% vs 8%, respectively, p=0.051). A multivariable analysis revealed the macroscopic depressed type to be characteristics of early gastric cancers after H. pylori eradication. Among patients in the Hp-eradicated group, metachronous cancers showed less frequent depressed lesions (68% vs 84%, respectively, p=0.049) and smaller tumor sizes (median, 11 mm vs 14 mm, respectively, p=0.014) than primary cancers. CONCLUSIONS: Early gastric cancers after H. pylori eradication are characterized by a depressed configuration. Careful follow-up endoscopies are necessary after H. pylori eradication.
