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Effect of eradication of Helicobacter pylori on incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer : an open-label, randomised controlled trial

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Title: Effect of eradication of Helicobacter pylori on incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer : an open-label, randomised controlled trial
Other Titles: metachronous gastric cancer and H. pylori eradication
Authors: Fukase, Kazutoshi Browse this author
Kato, Mototsugu Browse this author →KAKEN DB
Kikuchi, Shogo Browse this author
Inoue, Kazuhiko Browse this author
Uemura, Naomi Browse this author
Okamoto, Shiro Browse this author
Terao, Shuichi Browse this author
Amagai, Kenji Browse this author
Hayashi, Shunji Browse this author
Asaka, Masahiro Browse this author
Keywords: H. pylori treatment
Prevention
Recurrence
Endoscopic treatment
Issue Date: 2-Aug-2008
Publisher: Elsevier
Journal Title: The Lancet
Volume: 372
Issue: 9636
Start Page: 392
End Page: 397
Publisher DOI: 10.1016/S0140-6736(08)61159-9
Abstract: Background: Although the relationship between H.pylori infection and gastric cancer has been proved in epidemiological studies and animal experiments, prophylactic effect of H. pylori eradication is controversial in human studies. Methods: We conducted a large-scale, multi-center, randomized controlled open-labeled study to determine whether eradication of H. pylori had inhibitory effects on the development of metachronous gastric carcinomas after endoscopic resection. The study included 542 subjects including patients diagnosed with early gastric cancer, either newly diagnosed and planning to have endoscopic treatment; or in the post-resection follow-up phase after endoscopic treatment. They were randomly allocated to eradication and control arms and examined endoscopically at 6, 12, 24, and 36 months after allocation. Diagnosis of new carcinoma at another site of stomach was defined as primary endpoint. Metachronous cancers were confirmed through histological examination. Results Between eradication and control groups, there were no significant differences in baseline characteristics. Overall successful eradication rate was 79.6%. During follow-up of three years, metachronous gastric cancer developed in 33 cases, including 9 in the eradication group and 24 in the control group. The incidence of metachronous gastric cancer in eradication group was significantly lower than in control group both in the analysis ignoring observation period (Odds ratio: 0.353, 95% CI: 0.161-0.775, p=0.009) and in the analysis considering it (Hazard ratio: 0.34, 95% CI: 0.16-0.70, p=0.003). Kaplan–Meier analysis revealed that the cumulative incidence of gastric cancer was different between the two groups. Conclusions: This study showed that the eradication of H. pylori is indicated to prevent development of metachronous gastric cancers after endoscopic resection.
Relation: http://www.sciencedirect.com/science/journal/01406736
Type: article (author version)
URI: http://hdl.handle.net/2115/34681
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 浅香 正博

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