Background and Aims
Helicobacter pylori eradication can reduce the risk of metachronous lesions after the treatment of early
gastric cancer. We aimed to analyze the impact of the timing of H pylori eradication on metachronous recurrence.
Methods
Data of patients who underwent endoscopic resection or partial gastrectomy for early
stage gastric cancer and received H pylori eradication therapy were obtained from the Korean National Health Insurance Service
database. Patients were classified into 3 groups according to the timing of the prescription
for H pylori eradication: preresection; within 1 year postresection; and >1 year postresection.
Results
Among 19,767 patients, 7452 and 12,315 underwent endoscopic resection and surgery,
respectively. The 5-year cumulative incidence of metachronous lesions after endoscopic
resection was 14.0% in the preresection group, 12.3% in the within 1 year postresection
group, and 16.9% in the >1 year postresection group. Surgery was performed in 1.2%
of the preresection group, 1.3% of the within 1 year postresection group, and 2.9%
of the >1 year postresection group. The within 1 year postresection group had a lower
risk of development of metachronous lesions than the >1 year postresection group (hazard
ratio [95% confidence interval]: after endoscopic resection, 0.79 [0.65–0.95]; after
surgery, 0.39 [0.28–0.53]). The risk of development of metachronous lesions did not
differ between the preresection and within 1 year postresection groups.
Conclusion
Prescription of H pylori eradication therapy within 1 year after gastric cancer treatment reduces the risk
of development of metachronous gastric neoplasms compared with a late prescription
of eradication therapy in patients undergoing endoscopic resection and those undergoing
surgery.
Abbreviations:
BMI (body mass index), CI (confidence interval), EGC (early gastric cancer), HR (hazard ratio), ICD-10 (International Statistical Classification of Diseases and Related Health Problems, 10th Revision), IQR (interquartile range), NHIS (National Health Insurance Service), RCT (randomized controlled trial)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: May 27, 2020
Accepted:
May 8,
2020
Received:
January 13,
2020
Footnotes
If you would like to chat with an author of this article, you may contact Dr Park at [email protected] .
DISCLOSURE: All authors disclosed no financial relationships.
Identification
Copyright
© 2020 by the American Society for Gastrointestinal Endoscopy
ScienceDirect
Access this article on ScienceDirectLinked Article
- Has the issue of the “point of no return” in gastric carcinogenesis already been resolved?Gastrointestinal EndoscopyVol. 94Issue 1
- PreviewWe have read the article focusing on the timing of Helicobacter pylori eradication on the risk of development of metachronous gastric cancer (MGC) after treatment of early gastric cancer (EGC) by Kim et al.1 The authors showed that the timing of H pylori eradication within 1 year after treatment was better to reduce the risk of development of MGC than the late timing based on a large-scale national insurance database. They described that this finding was supported by a randomized controlled study by Choi et al2 showing that H pylori eradication after endoscopic resection (ER) of EGC improved atrophy and intestinal metaplasia during the 3-year follow-up.
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