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

Fukase, Kazutoshi; Kato, Mototsugu; Kikuchi, Shogo; Inoue, Kazuhiko; Uemura, Naomi; Okamoto, Shiro; Terao, Shuichi; Amagai, Kenji; Hayashi, Shunji; Asaka, Masahiro

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

Fukase, Kazutoshi; Kato, Mototsugu; Kikuchi, Shogo et al.

The Lancet, 2008, 372(9636), 392-397

Permalink : https://hdl.handle.net/2115/34681

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アクセス権	open access
URI	https://hdl.handle.net/2115/34681
タイトル	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
その他のタイトル	metachronous gastric cancer and H. pylori eradication
著者	Fukase, Kazutoshi ; Kato, Mototsugu ; Kikuchi, Shogo ; Inoue, Kazuhiko ; Uemura, Naomi ; Okamoto, Shiro ; Terao, Shuichi ; Amagai, Kenji ; Hayashi, Shunji ; Asaka, Masahiro
著者名 Fukase, Kazutoshi
e-Rad_Researcher 60271673 著者名 Kato, Mototsugu
著者名 Kikuchi, Shogo
著者名 Inoue, Kazuhiko
著者名 Uemura, Naomi
著者名 Okamoto, Shiro
著者名 Terao, Shuichi
著者名 Amagai, Kenji
著者名 Hayashi, Shunji
著者名 Asaka, Masahiro
言語	英語
キーワード	H. pylori treatment
	Prevention
	Recurrence
	Endoscopic treatment
発行日	2008-08-02
出版者	Elsevier
収録物名	The Lancet
巻(号)	372(9636)
ページ	392-397
抄録	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.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
PISSN	0140-6736
EISSN	1474-547X
関連情報	URI http://www.sciencedirect.com/science/journal/01406736
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1016/S0140-6736(08)61159-9