Published in:
01-11-2020 | Helicobacter Pylori | Original Article
Effect of Helicobacter pylori eradication after subtotal gastrectomy on the survival rate of patients with gastric cancer: follow-up for up to 15 years
Authors:
Yonghoon Choi, Nayoung Kim, Chang Yong Yun, Yoon Jin Choi, Hyuk Yoon, Cheol Min Shin, Young Soo Park, Sang-Hoon Ahn, Do Joong Park, Hye Seung Lee, Ji-Won Kim, Jin Won Kim, Keun-Wook Lee, Won Chang, Ji Hoon Park, Yoon Jin Lee, Kyoung Ho Lee, Young Hoon Kim, Dong Ho Lee, Hyung-Ho Kim
Published in:
Gastric Cancer
|
Issue 6/2020
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Abstract
Objective
Helicobacter pylori (HP) is known to play an important role in the development of gastric cancer (GC). The aim of this study was to analyze the effect of HP eradication on the survival rate and cancer recurrence in patients who underwent subtotal gastrectomy for GC.
Design
Totally 1,031 patients diagnosed with gastric adenocarcinoma who received surgical treatment at the Seoul National University Bundang Hospital from 2003 to 2017 and positive for HP infection were analyzed. The overall and GC-related survival according to HP eradication were compared; risk factors for GC-specific death and cancer recurrence were analyzed, and propensity score matching (PSM) was performed.
Results
Statistically significant benefits of overall and GC-specific survival were observed in the eradicated group compared to the non-eradicated group (P < 0.001), and these benefits were maintained after PSM (P < 0.001) in both of early and advance stage. In Cox proportional hazards multivariate analyses, cancer stage (stage II, adjusted hazard ratio [aHR] = 9.33, P < 0.001; stage III or IV, aHR = 26.17, P < 0.001), and HP positivity (aHR = 3.41, P = 0.001) were independent risk factors for GC-specific death; cancer stage (cancer stage II, aHR = 7.08, P < 0.001; cancer stage III or IV, aHR = 19.64, P < 0.001) and HP positivity (aHR = 2.70; P = 0.005) were independent risk factors for cancer recurrence.
Conclusion
Our results suggest that HP needed to be conducted more intensively in patients who are surgically treated for GC, regardless of cancer stage.