The Colombian Chemoprevention Trial: 20-Year Follow-Up of a Cohort of Patients With Gastric Precancerous Lesions

Piazuelo, M. Blanca; Bravo, Luis Eduardo; Mera, Robertino M.; Camargo, M. Constanza; Bravo, Juan Carlos; Delgado, Alberto; Washington, Mary Kay; Rosero, Alicia; García, Luz Stella; Realpe, J.Luis; Cifuentes, Sandra P.; Morgan, Douglas R.; Peek, Richard M.; Correa, Pelayo; Wilson, Keith T.

doi:10.1053/j.gastro.2020.11.017

Cited by 78 publications

(52 citation statements)

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“…Normal gastric mucosa may be restored over time in some patients with AG after successful H pylori eradication, 72 although most patients may have passed a "point-of-no-return" in which the gastric mucosal damage cannot be reversed despite H pylori eradication. 73 For these patients, their risk remains elevated, particularly among those with extensive or moderate to severe atrophy (eg, OLGA/OLGIM III/IV), providing the clinical rationale for endoscopic surveillance even after successful H pylori eradication, a practice supported by international guidelines (Supplementary Table 1). Nevertheless, despite persistent signs of AG, H pylori eradication does still appear to reduce the risk of gastric cancer.…”

Section: Test and Treat For Helicobactor Pylorimentioning

confidence: 99%

AGA Clinical Practice Update on the Diagnosis and Management of Atrophic Gastritis: Expert Review

et al. 2021

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Section: Test and Treat For Helicobactor Pylorimentioning

confidence: 99%

AGA Clinical Practice Update on the Diagnosis and Management of Atrophic Gastritis: Expert Review

et al. 2021

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“…The main characteristics of the 12 articles are summarized in Table 1 . Among the 12 cohort studies, 10 were prospective cohort studies ( 18 – 20 , 22 – 28 ) and 2 were retrospective cohort studies ( 17 , 21 ); 4 studies were conducted in Asia ( 20 , 22 , 25 , 28 ), 7 were conducted in Europe ( 17 – 19 , 21 , 23 , 24 , 26 ), and 1 was conducted in South America ( 27 ). In total, 6,498 individuals were included in this meta-analysis, and the sample size of the included studies ranged from 62 to 2,980.…”

Section: Resultsmentioning

confidence: 99%

Gastric Cancer Risk of Intestinal Metaplasia Subtypes: A Systematic Review and Meta-Analysis of Cohort Studies

Yang

Fang

et al. 2021

Clin Transl Gastroenterol

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INTRODUCTION: Intestinal metaplasia (IM) is an independent risk factor for gastric cancer (GC). However, the subtypes of IM as a risk factor for GC remain controversial. We performed a systematic review and meta-analysis to evaluate the relationship between IM subtypes and GC risk. METHODS: Systematic searches were conducted in PubMed, EMBASE, and the Cochrane Library for published cohort studies of patients with complete IM (type I) or incomplete IM (type II or type III) from inception to May 15, 2021. We extracted relevant data and calculated pooled risk ratios (RRs) and 95% confidence intervals (CIs) comparing the GC risk with IM subtypes. RESULTS: Twelve cohort studies comprising 6,498 individuals were included in the study. Compared with complete IM, the pooled relative risk of GC risk of patients with incomplete IM was 5.16 (95% CI, 3.28–8.12), and the GC risk of type III IM was the highest, with a pooled relative risk of 2.88 (95% CI, 1.37–6.04) compared with that of type II. Compared with complete IM, the pooled relative risk of dysplasia risk in patients with incomplete IM was 3.72 (95% CI, 1.42–9.72), and the dysplasia risk of type III IM was 11.73 (95% CI, 2.08–66.08) compared with that of type I. DISCUSSION: Patients with incomplete IM, especially type III, were at a higher risk of GC and dysplasia than those with complete IM. The current evidence indicates a potential correlation between IM subtypes and GC risk, which may support the use of IM subtypes in GC surveillance.

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“…Nonetheless, a prospective study of this scale on gastric cancer development among H pylori eradicated subjects is difficult due to the long lag time and relatively low incidence of gastric cancer development (5‐year risk of 0.21% in this study). It is important to note that previous studies showed that the 5‐year cumulative incidence of gastric cancer even among patients with intestinal metaplasia was 0.7%‐0.9% only 29,30 . Moreover, as these patients did not have serial follow‐up endoscopy and biopsy to look for development of gastric premalignant lesions.…”

Section: Discussionmentioning

confidence: 93%

“…It is important to note that previous studies showed that the 5-year cumulative incidence of gastric cancer even among patients with intestinal metaplasia was 0.7%-0.9% only. 29,30 Moreover, as these patients did not have serial follow-up endoscopy and biopsy to look for development of gastric premalignant lesions. These intermediate outcomes could not be used in this study.…”

Section: Subgroup Analysis According To Patient's Diagnosismentioning

confidence: 99%

Applications of machine learning models in the prediction of gastric cancer risk in patients after Helicobacter pylori eradication

Leung

Cheung

et al. 2021

Aliment Pharmacol Ther

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SummaryBackgroundThe risk of gastric cancer after Helicobacter pylori (H. pylori) eradication remains unknown.AimTo evaluate the performances of seven different machine learning models in predicting gastric cancer risk after H. pylori eradication.MethodsWe identified H. pylori‐infected patients who had received clarithromycin‐based triple therapy between 2003 and 2014 in Hong Kong. Patients were divided into training (n = 64 238) and validation sets (n = 25 330), according to period of eradication therapy. The data were used to construct seven machine learning models to predict risk of gastric cancer development within 5 years after H. pylori eradication. A total of 26 clinical variables were input into these models. The performances were measured by the area under receiver operating characteristic curve (AUC) analysis.ResultsDuring a mean follow‐up of 4.7 years, 0.21% of H. pylori‐eradicated patients developed gastric cancer. Of the seven machine learning models, extreme gradient boosting (XGBoost) had the best performance in predicting cancer development (AUC 0.97, 95%CI 0.96‐0.98), and was superior to conventional logistic regression (AUC 0.90, 95% CI 0.84‐0.92). With the XGBoost model, the number of patients considered at high risk of gastric cancer was 6.6%, with miss rate of 1.9%. Patient age, presence of intestinal metaplasia, and gastric ulcer were the heavily weighted factors used by the XGBoost.ConclusionBased on simple baseline patient information, machine learning model can accurately predict the risk of post‐eradication gastric cancer. This model could substantially reduce the number of patients who require endoscopic surveillance.

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The Colombian Chemoprevention Trial: 20-Year Follow-Up of a Cohort of Patients With Gastric Precancerous Lesions

Cited by 78 publications

References 50 publications

AGA Clinical Practice Update on the Diagnosis and Management of Atrophic Gastritis: Expert Review

AGA Clinical Practice Update on the Diagnosis and Management of Atrophic Gastritis: Expert Review

Gastric Cancer Risk of Intestinal Metaplasia Subtypes: A Systematic Review and Meta-Analysis of Cohort Studies

Applications of machine learning models in the prediction of gastric cancer risk in patients after Helicobacter pylori eradication

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