Early detection of gastric cancer after Helicobacter pylori eradication due to endoscopic surveillance

doi:10.1111/hel.12503

. 2018 Aug;23(4):e12503.

doi: 10.1111/hel.12503. Epub 2018 Jun 20.

Early detection of gastric cancer after Helicobacter pylori eradication due to endoscopic surveillance

Kosuke Sakitani^{1

2}, Toshihiro Nishizawa^{1

3}, Masahide Arita¹, Shuntaro Yoshida^{1

4}, Yosuke Kataoka^{1

4}, Daisuke Ohki^{1

4}, Hiroharu Yamashita^{1

5}, Yoshihiro Isomura^{1

6}, Akira Toyoshima^{1

7}, Hidenobu Watanabe⁸, Toshiro Iizuka⁹, Yutaka Saito¹⁰, Junko Fujisaki¹¹, Naohisa Yahagi¹², Kazuhiko Koike⁴, Osamu Toyoshima¹

Affiliations

¹ Department of Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan.
² The Institute for Adult Diseases, Asahi Life Foundation, Tokyo, Japan.
³ Department of Gastroenterology, Tokyo Medical Center, National Hospital Organization, Tokyo, Japan.
⁴ Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
⁵ Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
⁶ Department of Gastroenterology, Kanto Central Hospital, Tokyo, Japan.
⁷ Department of Colorectal Surgery, Japanese Red Cross Medical Center, Tokyo, Japan.
⁸ Department of Pathology, PCL Japan, Tokyo, Japan.
⁹ Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
¹⁰ Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
¹¹ Department of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan.
¹² Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan.

PMID: 29924436
PMCID: PMC6055630
DOI: 10.1111/hel.12503

Early detection of gastric cancer after Helicobacter pylori eradication due to endoscopic surveillance

Kosuke Sakitani et al. Helicobacter. 2018 Aug.

. 2018 Aug;23(4):e12503.

doi: 10.1111/hel.12503. Epub 2018 Jun 20.

Authors

Affiliations

¹ Department of Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan.
² The Institute for Adult Diseases, Asahi Life Foundation, Tokyo, Japan.
³ Department of Gastroenterology, Tokyo Medical Center, National Hospital Organization, Tokyo, Japan.
⁴ Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
⁵ Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
⁶ Department of Gastroenterology, Kanto Central Hospital, Tokyo, Japan.
⁷ Department of Colorectal Surgery, Japanese Red Cross Medical Center, Tokyo, Japan.
⁸ Department of Pathology, PCL Japan, Tokyo, Japan.
⁹ Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
¹⁰ Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
¹¹ Department of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan.
¹² Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan.

PMID: 29924436
PMCID: PMC6055630
DOI: 10.1111/hel.12503

Abstract

Background: Helicobacter pylori eradication therapy is commonly performed to reduce the incidence of gastric cancer. However, gastric cancer is occasionally discovered even after successful eradication therapy. Therefore, we examined the prognosis of gastric cancer patients, diagnosed after successful H. pylori eradication therapy.

Materials and methods: All-cause death rates and gastric cancer-specific death rates in gastric cancer patients who received successful H. pylori eradication treatment was tracked and compared to rates in patients who did not receive successful eradication therapy.

Results: In total, 160 gastric cancer patients were followed-up for up to 11.7 years (mean 3.5 years). Among them, 53 gastric cancer patients received successful H. pylori eradication therapy prior to gastric cancer diagnosis. During the follow-up period, 11 all-cause deaths occurred. In the successful eradication group, the proportion of patients with cancer stage I was higher. The proportions of patients who received curative endoscopic therapy and endoscopic examination in the 2 years prior to gastric cancer diagnosis were also higher in the successful eradication group. Kaplan-Meier analysis of all-cause death and gastric cancer-specific death revealed a lower death rate in patients in the successful eradication group (P = .0139, and P = .0396, respectively, log-rank test). The multivariate analysis showed that endoscopy within 2 years before cancer diagnosis is associated with stage I cancer.

Conclusions: Possible early discovery of gastric cancer after H. pylori eradication due to regular endoscopic surveillance may contribute to better prognosis of patients with gastric cancer.

Keywords: H. pylori eradication; endoscopic surveillance; gastric cancer; mortality rate.

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Figures

**Figure 1**
Kaplan–Meier analysis of the proportions of patients free of death in the *Helicobacter pylori* persistent infection group and successful *H. pylori* eradication group. A, Kaplan–Meier analysis and log‐rank test of the proportions of patients free of all‐cause death in the *H. pylori* persistent infection group and the successful *H. pylori* eradication group. B, Kaplan–Meier analysis and log‐rank test of the proportions of patients free of gastric cancer death in the *H. pylori* persistent infection group and the successful *H. pylori* eradication group

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References

1. Uemura N, Okamoto S, Yamamoto S, et al. Helicobacter pylori infection and the development of gastric cancer. N Engl J Med. 2001;345:784‐789. - PubMed
1. Sakitani K, Hirata Y, Watabe H, et al. Gastric cancer risk according to the distribution of intestinal metaplasia and neutrophil infiltration. J Gastroenterol Hepatol. 2011;26:1570‐1575. - PubMed
1. Shichijo S, Hirata Y, Sakitani K, et al. Distribution of intestinal metaplasia as a predictor of gastric cancer development. J Gastroenterol Hepatol. 2015;30:1260‐1264. - PubMed
1. Van Cutsem E, Sagaert X, Topal B, Haustermans K, Prenen H. Gastric cancer. Lancet. 2016;388:2654‐2664. - PubMed
1. Charalampakis N, Economopoulou P, Kotsantis I, et al. Medical management of gastric cancer: a 2017 update. Cancer Med. 2018;7:123‐133. - PMC - PubMed

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[1] Uemura N, Okamoto S, Yamamoto S, et al. Helicobacter pylori infection and the development of gastric cancer. N Engl J Med. 2001;345:784‐789. - PubMed

[2] Uemura N, Okamoto S, Yamamoto S, et al. Helicobacter pylori infection and the development of gastric cancer. N Engl J Med. 2001;345:784‐789. - PubMed

[3] Sakitani K, Hirata Y, Watabe H, et al. Gastric cancer risk according to the distribution of intestinal metaplasia and neutrophil infiltration. J Gastroenterol Hepatol. 2011;26:1570‐1575. - PubMed

[4] Sakitani K, Hirata Y, Watabe H, et al. Gastric cancer risk according to the distribution of intestinal metaplasia and neutrophil infiltration. J Gastroenterol Hepatol. 2011;26:1570‐1575. - PubMed

[5] Shichijo S, Hirata Y, Sakitani K, et al. Distribution of intestinal metaplasia as a predictor of gastric cancer development. J Gastroenterol Hepatol. 2015;30:1260‐1264. - PubMed

[6] Shichijo S, Hirata Y, Sakitani K, et al. Distribution of intestinal metaplasia as a predictor of gastric cancer development. J Gastroenterol Hepatol. 2015;30:1260‐1264. - PubMed

[7] Van Cutsem E, Sagaert X, Topal B, Haustermans K, Prenen H. Gastric cancer. Lancet. 2016;388:2654‐2664. - PubMed

[8] Van Cutsem E, Sagaert X, Topal B, Haustermans K, Prenen H. Gastric cancer. Lancet. 2016;388:2654‐2664. - PubMed

[9] Charalampakis N, Economopoulou P, Kotsantis I, et al. Medical management of gastric cancer: a 2017 update. Cancer Med. 2018;7:123‐133. - PMC - PubMed

[10] Charalampakis N, Economopoulou P, Kotsantis I, et al. Medical management of gastric cancer: a 2017 update. Cancer Med. 2018;7:123‐133. - PMC - PubMed

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Early detection of gastric cancer after Helicobacter pylori eradication due to endoscopic surveillance

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Early detection of gastric cancer after Helicobacter pylori eradication due to endoscopic surveillance

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