Choi, Jeongmin; Kim, Sang Gyun; Yoon, Hyuk; Im, Jong Pil; Kim, Joo Sung; Kim, Woo Ho; Jung, Hyun Chae
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
2014May ; 12 ( 5 ) :793-800.e1.
PMID : 24100112
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Choi, Jeongmin - Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Kim, Sang Gyun - Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea. Electronic address harley1333@hanmail.net.
Yoon, Hyuk - Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Im, Jong Pil - Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Kim, Joo Sung - Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Kim, Woo Ho - Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
Jung, Hyun Chae - Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
ABSTRACT
BACKGROUND & AIMS: It is not clear whether eradication of Helicobacter pylori infection reduces the risk for metachronous gastric carcinoma. We performed a prospective, randomized, open-label trial of the effects of H pylori eradication on the incidence of metachronous carcinoma after endoscopic resection of gastric tumors.
METHODS: From April 2005 through February 2011 there were 901 consecutive patients with H pylori infection who had been treated with endoscopic resection for gastric dysplasia or cancer and who were assigned randomly to groups given therapy to eradicate the infection (n = 444) or no therapy (controls, n = 457). The eradication group received 20 mg omeprazole, 1 g amoxicillin, and 500 mg clarithromycin twice daily for 1 week. Patients underwent endoscopic examination 3, 6, and 12 months after treatment, and then yearly thereafter. The primary outcome was development of metachronous gastric carcinoma.
RESULTS: During a median follow-up period of 3 years, 10 patients who received H pylori eradication and 17 controls developed metachronous carcinoma; this difference was not significant (P = .15). The incidence of metachronous carcinoma between the 2 groups did not differ significantly at 1, 2, 3, and 4 years after administration of the therapy. There were no significant differences in the development of metachronous carcinoma among patients who were positive (n = 16) or negative (n = 11) for H pylori infection (P = .32).
CONCLUSIONS: In this prospective trial, eradication of H pylori after endoscopic resection of gastric tumors did not significantly reduce the incidence of metachronous gastric carcinoma. ClinicalTrials.gov Number: NCT01510730. CI - Copyright ??2014 AGA Institute. Published by Elsevier Inc. All rights reserved.
keyword
Clinical Trial; Helicobacter pylori; Stomach Neoplasm; Therapy
MESH
Adult, Aged, Anti-Bacterial Agents/*therapeutic use, Anti-Ulcer Agents/*therapeutic use, Carcinoma/*epidemiology/surgery, Endoscopy/*methods, Female, Helicobacter Infections/*complications/*drug therapy, Humans, Incidence, Male, Middle Aged, Prospective Studies, Stomach Neoplasms/*epidemiology/surgery, Treatment Outcome
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