Characteristics of primary and metachronous gastric cancers discovered after helicobacter pylori eradication: A multicenter propensity score-matched study

Yuji Maehata, Shotaro Nakamura, Motohiro Esaki, Fumie Ikeda, Tomohiko Moriyama, Risa Hida, Ema Washio, Junji Umeno, Minako Hirahashi, Takanari Kitazono, Takayuki Matsumoto

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Background/Aims: Gastric cancers develop even after successful Helicobacter pylori eradication. We aimed to clarify the characteristics of early gastric cancers discovered after H. pylori eradication. Methods: A total of 1,053 patients with early gastric cancer treated by endoscopic submucosal dissection were included. After matching the propensity score, we retrospectively investigated the clinicopathological features of 192 patients, including 96 patients who had under-gone successful H. pylori eradication (Hp-eradicated group) and 96 patients who had active H. pylori infection (Hp-positive group). Results: In the Hp-eradicated group, early gastric cancers were discovered 1 to 15 years (median, 4.1 years) after H. pylori eradication. Compared with Hp-positive patients, Hp-eradicated patients showed a more frequently depressed configuration (81% vs 53%, respectively, p<0.0001) and a higher trend toward submucosal invasion (18% vs 8%, respectively, p=0.051). A multivariable analysis revealed the macroscopic depressed type to be characteristics of early gastric cancers after H. pylori eradication. Among patients in the Hp-eradicated group, metachronous cancers showed less frequent depressed lesions (68% vs 84%, respectively, p=0.049) and smaller tumor sizes (median, 11 mm vs 14 mm, respectively, p=0.014) than primary cancers. Conclusions: Early gastric cancers after H. pylori eradication are characterized by a depressed configuration. Careful follow-up endoscopies are necessary after H. pylori eradication.

Original languageEnglish
Pages (from-to)628-634
Number of pages7
JournalGut and Liver
Issue number5
Publication statusPublished - Sep 2017


All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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