Metachronous gastric cancer risk after endoscopic resection of early gastric cancer and H. pylori status

Excerpt

Endoscopic resection for mucosal gastric cancer removes the tumor and surrounding mucosa. However, the remaining mucosa is also exposed to H. pylori, and possible carcinogens associated with metachronous gastric cancers may often develop in areas other than the resected primary tumor. Our first randomized study published in 2008 with an observation period of 3 years found that H. pylori eradication reduced the incidence of metachronous gastric cancer among patients who had undergone endoscopic resection of early gastric cancer [1]. Although a Korean randomized study with a similar protocol design contradicted our results [2], another Korean randomized study with a long-term follow-up confirmed that H. pylori eradication significantly inhibited occurrence of metachronous gastric carcinoma [3]. Furthermore, the preventive effect of gastric cancer development by H. pylori eradication was confirmed by five meta-analysis, including Xiao’s manuscript entitled, “Helicobacter pylori status and risks of metachronous recurrence after endoscopic resection of early gastric cancer: a systematic review and meta-analysis” in this issue [4‐8]. …