Effect of helicobacter pylori on prognosis of curatively resected gastric cancers in a population with high prevalence: Short-term results of a prospective study.

Abstract

152b Background: Although two prospective studies reported that negative H pylori is associated with good prognosis in Western countries, these results are not generally acceptable due to regional differences in H pylori virulence and incidence of gastric cancer. Here, we prospectively assessed the correlation between H pylori status of patients who underwent curative resection for treatment of gastric adenocarcinoma and their prognosis in Korea, where H pylori is highly prevalent in the population. Methods: Between 2006 and 2007, 192 patients who had undergone curative resection for treatment of gastric adenocarcinoma were prospectively enrolled. Of these patients, 18 patients were excluded due to inexact evaluation of H pylori status, and 174 patients were finally analyzed. Serologic testing for H pylori was assessed using an enzyme-linked immunosorbent assay kit for IgG, and histological presence was identified using Giemsa stain. Results: Of 174 patients, 111 patients (63.8%) who showed both serologically and histologically positive results were confirmed as having positive H pylori infection. H pylori status was not correlated with overall or disease-free survival. In term of patients who were diagnosed with AJCC stage III or IV, disease-free survival of patients with positive H pylori status was a significant predicting factor for recurrence longer than that of negative patients (p = 0.019). Negative H pylori status became a predicting factor for recurrence in multivariable analysis (RR = 2.724, 95% C.I.: 1.192-6.228). Conclusions: H pylori status did not show correlation with clinicopathologic factors of gastric adenocarcinoma in Korea. However, negative H pylori may be a predictive factor for recurrence in patients diagnosed with gastric adenocarcinoma of advanced status. Therefore, in H pylori endemic areas, patients diagnosed with locally advanced gastric cancer accompanied by negative H pylori status should be considered for an aggressive treatment strategy and close follow-up. In addition, correlation in an early stage should be confirmative through the results of longer follow-up. No significant financial relationships to disclose.