• Yuji Maehata, Shotaro Nakamura, Kiyoshi Fujisawa, Motohiro Esaki, Tomohiko Moriyama, Kouichi Asano, Yuta Fuyuno, Kan Yamaguchi, Issei Egashira, Hyonji Kim, Motonobu Kanda, Minako Hirahashi, and Takayuki Matsumoto.
• Department of Medicine and Clinical Science, Kyushu University, Fukuoka, Japan.
• Gastrointest. Endosc. 2012 Jan 1; 75 (1): 39-46.

BackgroundA prospective, randomized trial proved that Helicobacter pylori eradication significantly reduces the incidence of metachronous gastric cancer during a 3-year follow-up.ObjectiveTo investigate the long-term effect of H pylori eradication on the incidence of metachronous gastric cancer after endoscopic resection of early gastric cancer.DesignRetrospective, multicenter study.SettingKyushu University Hospital and 6 other hospitals in Fukuoka Prefecture, Japan.Patients And InterventionsFollow-up data for 268 H pylori-positive patients who had undergone endoscopic resection of early gastric cancer were retrospectively investigated. A total of 177 patients underwent successful H pylori eradication (eradicated group), whereas 91 had persistent H pylori infection (persistent group).Main Outcome MeasurementsThe incidence of metachronous gastric cancer was compared in these 2 groups.ResultsWhen the follow-up period was censored at 5 years, the incidence rate in the eradicated group was lower than that observed in the persistent group (P = .007). During the overall follow-up period ranging from 1.1 to 11.1 years (median 3.0 years), metachronous gastric cancer developed in 13 patients (14.3%) in the persistent group and in 15 patients (8.5%) in the eradicated group (P = .262, log-rank test). Based on a multivariate logistic regression analysis, baseline severe mucosal atrophy and a follow-up of more than 5 years were found to be independent risk factors for the development of metachronous gastric cancer.LimitationsRetrospective study.ConclusionsH pylori eradication does not reduce the incidence of metachronous gastric cancer. H pylori eradication should be performed before the progression of gastric mucosal atrophy.Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

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