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Hokkaido University Collection of Scholarly and Academic Papers >
Graduate School of Medicine / Faculty of Medicine >
Peer-reviewed Journal Articles, etc >
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
| 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)
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Submitter: 浅香 正博
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