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Independent risk factors for recurrence after endoscopic resection of gastric cancer

Failure of Helicobacter pylori eradication and age are independent risk factors for recurrent neoplasia after endoscopic resection of early gastric cancer, reports the latest issue of the Alimentary Pharmacology & Therapeutics.

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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).

Dr Jeon and colleagues from South Korea compared 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.

In a single center, between 2007 and 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 analyzed retrospectively.

The research team enrolled 283 patients who have shown H. pylori infection at the time of ESD for EGC.

51% did not include patient input in developing the patient-reported outcome
American Journal of Gastroenterology

Successful eradication was achieved for 76% of patients (Eradicated group), and 24% of patients showed persistent H. pylori infection (Persistent group).

The team observed that metachronous gastric lesions developed in 19% in the persistent group, and 8% in the eradicated group.

In the over 60-year-old group, the cumulative incidence of metachronous gastric cancer showed a significant increase.

The team noted that cumulative hazard ratio of subsequent gastric metachronous lesions differed between the eradication group and the persistent infection group, and over 60 age at the time of endoscopic resection.

Dr Jeon's team commented, "Both persistent H. pylori infection and old age (≥60) are independent risk factors for the increased incidence of metachronous gastric cancer."

Aliment Pharmacol Ther 2014: 39(6): 609–618
03 March 2014

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