Eradication of Helicobacter pylori for primary gastric cancer and secondary gastric cancer after endoscopic mucosal resection

Accession number;07A0177222
Title;Eradication of Helicobacter pylori for primary gastric cancer and secondary gastric cancer after endoscopic mucosal resection
Author; KATO MOTOSUGU (Hokkaido Univ. Hospital, Sapporo, Jpn) ASAKA MASAHIRO (Hokkaido Univ. Graduate School Of Medicine, Sapporo, Jpn) ONO SHOUKO (Hokkaido Univ. Hospital, Sapporo, Jpn) NAKAGAWA MANABU (Hokkaido Univ. Hospital, Sapporo, Jpn) NAKAGAWA SOUICHI (Hokkaido Univ. Hospital, Sapporo, Jpn) SHIMIZU YUICHI (Hokkaido Univ. Hospital, Sapporo, Jpn) CHUMA MAKOTO (Hokkaido Univ. Graduate School Of Medicine, Sapporo, Jpn) KAWAKAMI HIROSHI (Hokkaido Univ. Graduate School Of Medicine, Sapporo, Jpn) KOMATSU YOSHITO (Hokkaido Univ. Graduate School Of Medicine, Sapporo, Jpn) HIGE SHUHEI (Hokkaido Univ. Graduate School Of Medicine, Sapporo, Jpn) TAKEDA HIROSHI (Hokkaido Univ. Graduate School Of Medicine, Sapporo, Jpn)
Journal Title;J Gastroenterol
Journal Code:Z0748A
ISSN:0944-1174
VOL.42;NO.Supplement 17;PAGE.16-20(2007)
Figure&Table&Reference;
Pub. Country;Japan
Language;English
Abstract;Because most gastric cancers develop from a background of Helicobacter pylori-infected gastric mucosa, H. pylori plays an important role in gastric carcinogenesis. Therefore, eradication of H. pylori may inhibit the incidence of gastric cancers. In experimental studies, H. pylori eradication has proved to act as a prophylaxis against gastric cancer. However, the results of recent randomized controlled studies are absolutely contradictory. In Japan, mucosal gastric cancer is usually resected by endoscopic treatment. As only a small part of the gastric mucosa is resected, secondary gastric cancer after endoscopic resection of the primary gastric cancer often develops at another site in the stomach. A nonrandomized Japanese study involving 132 early gastric cancer patients reported that eradication of H. pylori after endoscopic resection tended to reduce the development of secondary gastric cancer. Also, a retrospective multicenter survey indicated that the incidence rate of secondary gastric cancer in H. pylori-eradicated patients was about one-third that among patients in the noneradication group. We conducted a large-scale multicenter randomized trial to confirm the effect of H. pylori eradication on secondary and residual gastric cancer after endoscopic resection. This study was begun in 2003 and is ongoing at present. Diagnosis of a new carcinoma at another site of the stomach is defined as the primary end point, and recurrence of tumors at the resection site as a secondary end point. A total of 542 subjects have been enrolled in the study. This study will have the statistical power to demonstrate whether H. pylori eradication decreases the incidence and recurrence of gastric cancer. (author abst.)