Helicobacter pylori (H. pylori) infection is prevalent and has a rapidly increasing antibiotic resistance rate in Vietnam. Reinfection is quite common, and gastric carcinoma remains one of the most common malignancies, which is not uncommon to develop after successful eradication. The purpose of this consensus is to provide updated recommendations on the management of H. pylori infection in the country. The consensus panel consisted of 32 experts from 14 major universities and institutions in Vietnam who were invited to review the evidence and develop the statements using the Delphi method. The process followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. The consensus level was defined as ≥80% for agreement on the proposed statements. Due to the limited availability of high-quality local evidence, this consensus was also based on high-quality evidence from international studies, especially those conducted in other populations in the Asia–Pacific region. The panel finally reached a consensus on 27 statements after two voting rounds, which consisted of four sections (1) indications for testing and selection of diagnostic tests (2), treatment regimens, (3) post-treatment confirmation of H. pylori status, and (4) reinfection prevention methods and follow-up after eradication. Important issues that require further evidence include studies on third-line regimens, strategies to prevent H. pylori reinfection, and post-eradication follow-up for precancerous gastric lesions. We hope this consensus will help guide the current clinical practice in Vietnam and promote multicenter studies in the country and international collaborations.

Introduction. Survival outcomes in patients with unresectable colorectal cancer (CRC) liver metastasis treated by radiofrequency ablation (RFA) combined with systemic chemotherapy and correlation with potential prognostic factors were investigated. Material and Methods. A retrospective cohort study was conducted on 61 CRC patients with unresectable liver metastasis who underwent liver tumor-directed percutaneous RFA combined with conventional systemic chemotherapy between October 2013 and September 2018. Survival analyses were conducted using the Kaplan-Meier method, and the log-rank test was used to characterize differences in the median survival time and the 1-year, 3-year, and 5-year overall survival rates of subgroups to identify prognostic factors. Results. Median overall survival and progression-free survival of all patients were 32 and 14 months, respectively. The cumulative survival rates at 1-, 3-, and 5-years were 93.2%; 44.5%, and 38.2%, respectively. Univariate analysis revealed that pre-RFA serum CEA levels, Eastern Cooperative Oncology Group (ECOG) status, number of liver lesions, the size of the largest lesion, and the total lesion size were prognostic factors. However, multivariate analysis demonstrated that only the number of liver lesions and the size of the largest lesion were independent prognostic factors for survival. Conclusion. RFA plus systemic chemotherapy provides an encouraging survival outcome for patients with unresectable CRC liver metastasis. Multivariate analysis demonstrated that the number and size of liver metastatic lesions are independent prognostic factors for survival.

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The study aimed to evaluate the safety and effectiveness of selective internal radiation therapy (SIRT) in patients with unresectable hepatocellular carcinoma (HCC) in Vietnam. A single-arm, multicenter, prospective observational study on the use of SIRT in patients with HCC was conducted with 6 months of patient follow-up. At baseline, eligible patients had Eastern Cooperative Oncology Group (ECOG) status ≤1, total bilirubin ≤2 mg/dL, tumor burden ≤50%, Child-Pugh score A or ≤B7, and Barcelona Clinic Liver Cancer stage A – C. Patients with extrahepatic disease, signs of liver failure, or previous external beam radiation to the liver were excluded. Primary outcomes were tumor response according to modified Response Evaluation Criteria in Solid Tumors criteria, changes in liver function, and adverse events (AEs) assessed using Common Terminology for AEs v4.03 and the investigators’ clinical judgment. The secondary outcome was the percentage of patients alive at 6 months. Two centers enrolled 30 patients (median age 60 years) in 2017 and 2018. All patients were Child-Pugh A; among them, 28 were ECOG 0. Most had hepatitis B (n = 17, 57%) or D (n = 10, 33%). Target lesion response at 6 months was 23% complete response, 37% partial response, 7% stable disease, and 7% progressive disease. Of the 8 patients (27%) not evaluated, 2 had become eligible for resection, 2 had contraindications to imaging, and 4 were lost to follow-up. Laboratory values, including α-fetoprotein, did not change significantly from baseline to 6 months. The most common AEs were abdominal pain (37%) and vomiting (17%). Nine episodes of abdominal pain in 6 patients were treatment-related. Serious AEs included progressive cirrhosis (n = 1) and progression of HCC (n = 5). All patients were alive at 6 months. In conclusion, the safety and clinical effectiveness of SIRT were confirmed in patients with unresectable HCC in Vietnam.

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