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Incidence of and risk factors for metachronous gastric cancer after endoscopic resection and successful Helicobacter pylori eradication: results of a large-scale, multicenter cohort study in Japan.
Gastric Cancer. 2016 Jul; 19(3):911-8.GC

Abstract

BACKGROUND

A previous multicenter prospective randomized study from Japan showed that Helicobacter pylori eradication reduced the development of metachronous gastric cancer (MGC) after endoscopic resection for early gastric cancer. MGC risk, however, is not eliminated; yet few studies have evaluated its long-term incidence and risk factors. In this study, we investigated the incidence of and risk factors for MGC in patients who underwent endoscopic resection for early gastric cancer with successful H. pylori eradication.

METHODS

A total of 594 patients who underwent endoscopic resection for early gastric cancer and successful H. pylori eradication at three institutions (National Cancer Center Hospital, University of Tokyo Hospital, and Wakayama Medical University Hospital) were analyzed retrospectively. Annual endoscopic surveillance was performed after initial endoscopic resection. MGC was defined as a gastric cancer newly detected at least 1 year after successful H. pylori eradication.

RESULTS

Ninety-four MGCs were detected in 79 patients during the 4.5-year median follow-up period. Kaplan-Meier analysis showed the cumulative incidence of MGC 5 years after successful H. pylori eradication was 15.0 %; the incidence of MGC calculated by use of the person-year method was 29.9 cases per 1000 person-years. Multivariate analysis using the Cox proportional hazards model revealed that male sex, severe gastric mucosal atrophy, and multiple gastric cancers before successful H. pylori eradication were independent risk factors for MGC. Eleven percent of MGCs (10 of 94) were detected more than 5 years after successful H. pylori eradication.

CONCLUSION

Surveillance endoscopy for MGC in patients who have undergone endoscopic resection for early gastric cancer should be performed even after successful H. pylori eradication.

Authors+Show Affiliations

Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. tnakajim@ncc.go.jp.Division of Epigenomics, National Cancer Center Research Institute, Tokyo, Japan.Epidemiology and Prevention Group, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.Department of Gastroenterology, University of Tokyo, Tokyo, Japan.Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan.Department of Gastroenterology, University of Tokyo, Tokyo, Japan.Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.Division of Epigenomics, National Cancer Center Research Institute, Tokyo, Japan.Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

26420267

Citation

Mori, Genki, et al. "Incidence of and Risk Factors for Metachronous Gastric Cancer After Endoscopic Resection and Successful Helicobacter Pylori Eradication: Results of a Large-scale, Multicenter Cohort Study in Japan." Gastric Cancer : Official Journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, vol. 19, no. 3, 2016, pp. 911-8.
Mori G, Nakajima T, Asada K, et al. Incidence of and risk factors for metachronous gastric cancer after endoscopic resection and successful Helicobacter pylori eradication: results of a large-scale, multicenter cohort study in Japan. Gastric Cancer. 2016;19(3):911-8.
Mori, G., Nakajima, T., Asada, K., Shimazu, T., Yamamichi, N., Maekita, T., Yokoi, C., Fujishiro, M., Gotoda, T., Ichinose, M., Ushijima, T., & Oda, I. (2016). Incidence of and risk factors for metachronous gastric cancer after endoscopic resection and successful Helicobacter pylori eradication: results of a large-scale, multicenter cohort study in Japan. Gastric Cancer : Official Journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 19(3), 911-8. https://doi.org/10.1007/s10120-015-0544-6
Mori G, et al. Incidence of and Risk Factors for Metachronous Gastric Cancer After Endoscopic Resection and Successful Helicobacter Pylori Eradication: Results of a Large-scale, Multicenter Cohort Study in Japan. Gastric Cancer. 2016;19(3):911-8. PubMed PMID: 26420267.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incidence of and risk factors for metachronous gastric cancer after endoscopic resection and successful Helicobacter pylori eradication: results of a large-scale, multicenter cohort study in Japan. AU - Mori,Genki, AU - Nakajima,Takeshi, AU - Asada,Kiyoshi, AU - Shimazu,Taichi, AU - Yamamichi,Nobutake, AU - Maekita,Takao, AU - Yokoi,Chizu, AU - Fujishiro,Mitsuhiro, AU - Gotoda,Takuji, AU - Ichinose,Masao, AU - Ushijima,Toshikazu, AU - Oda,Ichiro, Y1 - 2015/09/29/ PY - 2015/05/28/received PY - 2015/09/07/accepted PY - 2015/10/1/entrez PY - 2015/10/1/pubmed PY - 2017/4/5/medline KW - Gastric cancer KW - Helicobacter pylori KW - Incidence KW - Multivariate analysis KW - Risk factors SP - 911 EP - 8 JF - Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association JO - Gastric Cancer VL - 19 IS - 3 N2 - BACKGROUND: A previous multicenter prospective randomized study from Japan showed that Helicobacter pylori eradication reduced the development of metachronous gastric cancer (MGC) after endoscopic resection for early gastric cancer. MGC risk, however, is not eliminated; yet few studies have evaluated its long-term incidence and risk factors. In this study, we investigated the incidence of and risk factors for MGC in patients who underwent endoscopic resection for early gastric cancer with successful H. pylori eradication. METHODS: A total of 594 patients who underwent endoscopic resection for early gastric cancer and successful H. pylori eradication at three institutions (National Cancer Center Hospital, University of Tokyo Hospital, and Wakayama Medical University Hospital) were analyzed retrospectively. Annual endoscopic surveillance was performed after initial endoscopic resection. MGC was defined as a gastric cancer newly detected at least 1 year after successful H. pylori eradication. RESULTS: Ninety-four MGCs were detected in 79 patients during the 4.5-year median follow-up period. Kaplan-Meier analysis showed the cumulative incidence of MGC 5 years after successful H. pylori eradication was 15.0 %; the incidence of MGC calculated by use of the person-year method was 29.9 cases per 1000 person-years. Multivariate analysis using the Cox proportional hazards model revealed that male sex, severe gastric mucosal atrophy, and multiple gastric cancers before successful H. pylori eradication were independent risk factors for MGC. Eleven percent of MGCs (10 of 94) were detected more than 5 years after successful H. pylori eradication. CONCLUSION: Surveillance endoscopy for MGC in patients who have undergone endoscopic resection for early gastric cancer should be performed even after successful H. pylori eradication. SN - 1436-3305 UR - https://www.unboundmedicine.com/medline/citation/26420267/Incidence_of_and_risk_factors_for_metachronous_gastric_cancer_after_endoscopic_resection_and_successful_Helicobacter_pylori_eradication:_results_of_a_large_scale_multicenter_cohort_study_in_Japan_ L2 - http://dx.doi.org/10.1007/s10120-015-0544-6 DB - PRIME DP - Unbound Medicine ER -