In a retrospective study by Bae et al. [11] on 1007 Korean patients who underwent endoscopic resection for early GC between November 2004 and December 2008, rates of metachronous cancer in the H. pylori-negative, Alectinib cell line eradicated, and noneradicated groups were 10.9, 14.7, and 29.7 cases per 1000 person-years, respectively. The median time for metachronous recurrence was 18 months (range, 7–75 months). There were no significant differences in the recurrence rate and recurrence-free survival between the H. pylori-negative and eradicated groups, but the recurrence rate was significantly higher in the noneradicated than in the H. pylori-negative and eradicated groups.
The hazard ratios in the noneradicated group compared with the H. pylori-negative and eradicated groups were 2.5 (p < .01) and 1.9 (p = .02), respectively. On the basis of their results, the authors concluded that successful H. pylori eradication may reduce the occurrence of metachronous GC after endoscopic resection in patients with early GC. In a prospective,
randomized, open-label trial evaluating the effects of H. pylori eradication on the incidence of metachronous carcinoma after endoscopic resection of early GC, 901 consecutive Korean MI-503 patients with H. pylori infection who had been treated with endoscopic resection for gastric dysplasia or cancer from April 2005 to February 2011 were randomly assigned to a PPI-based triple therapy (20 mg omeprazole, 1 g amoxicillin, and 500 mg clarithromycin twice daily for 1 week) or no therapy [12]. Patients underwent endoscopic examination MCE公司 3, 6, and 12 months after treatment and then yearly thereafter. 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 two 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). Thus, in contrast to the previous retrospective study, in the prospective trial, eradication of H. pylori did not reduce the incidence of metachronous gastric carcinoma after endoscopic resection of gastric tumors. A multicentre retrospective cohort study from 12 hospitals aimed at elucidating the time at which multiple GCs develop and determining whether scheduled endoscopic surveillance might control their development [13]; 1258 Japanese patients with early GC (EGC) who underwent endoscopic submucosa dissection (ESD) with en bloc margin-negative curative resection from April 1999 to December 2010 were included. Synchronous cancer was classified as concomitant cancer or missed cancer. Follow-up endoscopy was performed every 6–12 months. Synchronous or metachronous multiple cancers were detected in 175 patients (13.