Negative <i>Helicobacter pylori</i> status is associated with poor prognosis in patients with gastric cancer

Marrelli, Daniele; Pedrazzani, Corrado; Berardi, Anna; Corso, Giovanni; Neri, Alessandro; Garosi, Lorenzo; Vindigni, Carla; Santucci, Annalisa; Figura, Natale; Roviello, Franco

doi:10.1002/cncr.24253

Cited by 91 publications

(128 citation statements)

References 44 publications

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“…pylori infection may be localized in or around the tumour (classified as diffuse, localized, or none). 17 . An overall positivity rate of 72.0% was observed in our patients.…”

Section: Discussionmentioning

confidence: 99%

“…Patients positive for H. pylori showed improved os and relapse-free survival. A prospective study by Marrelli et al 17 indicated that negative H. pylori status was an indicator of poor prognosis in patients with gastric cancer.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, no method of H. pylori detection is perfect. For example, Marrelli et al 17 reported that 14% of polymerase chain reaction-positive gastric cancer patients demonstrated negative serology for H. pylori. The role of serology tests therefore remains questionable for other than epidemiologic purposes.…”

Section: Discussionmentioning

confidence: 99%

“…Based on an association between H. pylori infection and the risk of gastric cancer, some investigations have focused on the relationship between H. pylori status and gastric cancer prognosis [15][16][17][18][19] . Currently, the available data suggest a controversial role of H. pylori infection in the prognosis of patients with gastric cancer, and because of regional differences in H. pylori prevalence and gastric cancer incidence, the effect of H. pylori status on prognosis should be determined in various areas.…”

Section: Positivity For H Pylori Infection Was Observed Inmentioning

confidence: 99%

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Helicobacter pylori Infection Predicts Favorable Outcome in Patients with Gastric Cancer

et al. 2013

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“…pylori infection may be localized in or around the tumour (classified as diffuse, localized, or none). 17 . An overall positivity rate of 72.0% was observed in our patients.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Positivity For H Pylori Infection Was Observed Inmentioning

confidence: 99%

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Helicobacter pylori Infection Predicts Favorable Outcome in Patients with Gastric Cancer

et al. 2013

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“…Marrelli et al [18] have reported that the vacA gene encodes the vacuolating cytokine VacA, which induces epithelial cell injury, and the degree of heterogeneity in vacA may be useful as a marker for peptic ulcer diseases.…”

Section: Frequencies Of Duodenal Ulcer and Gastric Cancermentioning

confidence: 99%

Why is the coexistence of gastric cancer and duodenal ulcer rare? Examination of factors related to both gastric cancer and duodenal ulcer

et al. 2011

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The coexistence of gastric cancer with duodenal ulcer has been found empirically to be rare, but why it is rare is difficult to explain satisfactorily. To elucidate this question, we carried out a literature review of the subject. The frequency with which the two diseases coexist is 0.1-1.7%, and the main factor associated with both gastric cancer and duodenal ulcer is Helicobacter pylori infection. However, there are marked differences between the disorders of hyperchlorhydria in duodenal ulcer, and hypochlorhydria in gastric cancer. The most acceptable view of the reason for the difference may be that the acquisition of H. pylori infection occurs mainly in childhood, so that the time of acquisition of atrophic gastritis may be the most important, and if atrophic gastritis is not acquired early, high levels of gastric acid may occur, and consequently acute antral gastritis and duodenal ulcer may occur in youth, whereas, in elderly individuals, persistent H. pylori infections and the early appearance of atrophic gastritis may be the causes of low gastric acid, and consequently gastric cancer may occur. In patients with duodenal ulcer, factors such as nonsteroidal anti-inflammatory drugs (NSAIDs) and dupA-H. pylori strains may contribute to preventing the early acquisition of atrophic gastritis, while acid-suppressive therapy and vascular endothelial growth factor and other entities may inhibit atrophic gastritis. In contrast, in gastric cancer, factors such as excessive salt intake, acid-suppressive therapy, polymorphisms of inflammatory cytokines, and the homB-H. pylori strain may contribute to the early acquisition of atrophic gastritis, while factors such as NSAIDs; fruits and vegetables; vitamins A, C, and E; and good nutrition may inhibit it.

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Anti–Helicobacter pylori Treatment in Patients With Gastric Cancer After Radical Gastrectomy

Zhao,

Zhang,

Chen

et al. 2024

JAMA Netw Open

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ImportanceWhether anti–Helicobacter pylori treatment can provide survival benefits for patients with gastric cancer who are diagnosed with H pylori infection is an area with limited research.ObjectiveTo explore the potential survival benefits of anti–H pylori treatment after radical gastrectomy in patients with gastric cancer and presurgical confirmation of H pylori infection.Design, Setting, and ParticipantsThis retrospective cohort study was conducted using data from patients with gastric cancer treated between January 1, 2010, and December 31, 2018, and followed up for outcome ascertainment until May 19, 2021. Propensity score matching was performed in patients treated with or without anti–H pylori treatment. This study involved a single institute in a comprehensive cancer treatment and research center located in Guangzhou, Guangdong Province, China. The study included patients with gastric or esophagogastric junction adenocarcinoma who underwent curative gastrectomy with D2 lymphadenectomy and tested positive for H pylori infection. Data were analyzed from March to June 2023.ExposureAnti–H pylori treatment, which primarily includes triple therapy regimens consisting of amoxicillin, clarithromycin, and omeprazole for 14 days.Main Outcomes and MeasuresClinical outcomes, including overall survival (OS) and disease-free survival (DFS), were analyzed by Kaplan-Meier method, log-rank test, and Cox proportional hazards regression model. Subgroup analysis based on crucial clinical information was also conducted.ResultsAll 1293 patients (median [IQR] age, 59 [50-65] years; 860 [66.5%] male) were divided into 2 groups, with 125 patients in the anti–H pylori treatment group and 1168 patients in the non–anti–H pylori treatment group based on whether they received anti–H pylori treatment during the perioperative period and the follow-up. Survival analysis showed that the 5-year OS rates were 94.1% (95% CI, 89.3%-99.2%) in the anti–H pylori group and 73.8% (95% CI, 70.7%-77.0%) in the non–anti–H pylori group, and the hazard ratio (HR) of these 2 groups was 0.33 (95% CI, 0.18-0.60; P &lt; .001). The survival benefit remained after propensity score matching (HR, 0.50; 95% CI, 0.26-0.99; P = .048). Multivariable analysis for OS and DFS further showed the survival benefit of anti–H pylori treatment, with HRs of 0.38 (95% CI, 0.17-0.87; P = .02) and 0.48 (95% CI, 0.28-0.83; P = .008), respectively. Among patients with TNM stage II/III disease who received adjuvant chemotherapy, anti–H pylori treatment was associated with survival benefits (OS: HR, 0.49; 95% CI, 0.24-0.99; P = .046), whereas among those who did not receive adjuvant chemotherapy, anti–H pylori treatment was not associated with survival benefits (OS: HR, 0.29; 95% CI, 0.04-2.08; P = .22).Conclusions and RelevanceThis cohort study indicates that anti–H pylori treatment may be associated with improved survival in patients with gastric cancer who have H pylori infections. The study reinforces the importance of including H pylori screening and treatment in the surgical treatment of these patients.

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Negative Helicobacter pylori status is associated with poor prognosis in patients with gastric cancer

Cited by 91 publications

References 44 publications

Helicobacter pylori Infection Predicts Favorable Outcome in Patients with Gastric Cancer

Helicobacter pylori Infection Predicts Favorable Outcome in Patients with Gastric Cancer

Why is the coexistence of gastric cancer and duodenal ulcer rare? Examination of factors related to both gastric cancer and duodenal ulcer

Anti–Helicobacter pylori Treatment in Patients With Gastric Cancer After Radical Gastrectomy

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