Helicobacter pylori — ein neuer unabhängiger Prognosefaktor nach kurativer Resektion beim Magenkarzinom

Abstract

Background: So far, the influence of Helicobacter pylori (H.p.) status on survival after curative resection for gastric adenocarcinoma is unknown. We report prospective follow-up data of H.p.-positive and -negative gastric cancer patients who underwent curative resection for gastric adenocarcinoma between 1992 and 1999. Methods: Preoperative H.p. status of 167 patients was examined by means of bacterial culture, histology (H&E and Warthin-Starry stain) and serology. We investigated associations with various prognostic factors as well as the effect of H.p. status on relapse-free and overall survival. Results: At median follow-up of 25.2 months, overall survival was 53.3% in H.p.-positive patients, and 22.1% in H.p.-negative patients (p = 0.003). For multivariate analysis of various clinicopathologic features, the effect of H.p. status emerged as a new independent prognostic factor (hazard ratio 0.58, 95% CI 0.34–0.98). Other established prognostic factors (depth of invasion, lymph node metastasis and preoperatively elevated levels of carcinoembryonic antigen) were also significantly linked with survival in our study. Discussion: H.p.-positive patients’ status is a new independent prognostic factor for better survival after curative resection for gastric adenocarcinoma. Our findings should lead to a more careful follow-up of H.p.-negative patients due to their dismal prognosis. If the mechanisms that lead to the reported differences in survival are elucidated, our findings could contribute to new strategies in the treatment of gastric cancer.