Long-term effect of Helicobacter pylori eradication on metachronous gastric cancer development

Abstract

Background: Gastric mucosal atrophy and intestinal metaplasia by Helicobacter pylori infection are the main precursor lesions of gastric cancer. This study aims to evaluate the long-term effect of Helicobacter pylori eradication on the progression of precancerous lesions to metachronous cancer development after endoscopic resection of early gastric cancer. Methods: The patients who underwent endoscopic resection of early gastric cancer were reviewed retrospectively. Changes in precancerous lesions and development of metachronous cancer were compared according to Helicobacter pylori eradication and final status of infection. Results: In total, 565 patients were followed up for over 5 years after endoscopic resection of early gastric cancer. The grade of mucosal atrophy on corpus was significantly lower in the eradicated group than the persistent group during follow-up (p=0.029). In patients less than 70 years of age, the cumulative incidence rate of metachronous cancer was significantly lower in the Helicobacter pylori-eradicated group than the Helicobacter pylori-persistent group (p = 0.018). Age was an independent risk factor for metachronous cancer development. Conclusions: Helicobacter pylori eradication might prevent the long-term development of metachronous cancer in younger patients by delaying the progression of precancerous lesions after endoscopic resection of early gastric cancer.