JAMA Netw Open
Does anti-H. pylori treatment after gastrectomy improve gastric cancer survival?
Among gastric cancer (GC) patients with pre-op confirmation of H. pylori infection, anti–H. pylori treatment may be associated with improved survival. Study results highlight the importance of including H. pylori screening and treatment in the surgical management of such patients.
This retrospective cohort study was conducted in China using data from patients treated between January 2010 and December 2018. The study population consisted of patients with gastric or esophagogastric junction adenocarcinoma who underwent curative gastrectomy with D2 lymphadenectomy and tested positive for H. pylori infection. Anti-H. pylori treatment primary consisted of triple-therapy regimens containing amoxicillin, clarithromycin, and omeprazole for 14 days.
Of 1,293 total patients (median age, 59 years; 66.5% male), 125 were in the anti-H. pylori treatment group and 1,168 were in the non-anti-H. pylori treatment group. Five-year overall survival (OS) rates were 94.1% in the anti-H. pylori group vs. 73.8% in the non-anti-H. pylori group (hazard ratio [HR], 0.33; 95% confidence interval [CI], 0.18-0.60; P < .001). Survival benefit remained after propensity score matching. Upon multivariable analysis, HRs for OS and disease-free survival (DFS) were 0.38 and 0.48, respectively. Anti-H. pylori treatment was associated with OS benefits among patients with TNM stage II/III disease who received adjuvant chemo, but not among those who didn’t receive adjuvant chemo.
Source:
Zhao Z, et al. (2024, March 28). JAMA Netw Open. Anti-Helicobacter pylori Treatment in Patients With Gastric Cancer After Radical Gastrectomy. https://pubmed.ncbi.nlm.nih.gov/38546641/