Multicenter study of invasive gastric cancer detected after 10 years of Helicobacter pylori eradication in Japan: Clinical, endoscopic, and histopathologic characteristics

Abstract Objectives Gastric cancer can be diagnosed even in patients long after Helicobacter pylori eradication. Most cases involve intramucosal lesions; however, some are invasive and require surgery. To clarify appropriate long‐term surveillance methods, this study compared invasive gastric cancer...

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Main Authors: Masaaki Kobayashi, Junko Fujisaki, Ken Namikawa, Shu Hoteya, Akiko Sasaki, Kotaro Shibagaki, Kenshi Yao, Seiichiro Abe, Ichiro Oda, Hiroya Ueyama, Hajime Isomoto, Masanori Ito, Mitsushige Sugimoto, Takashi Kawai, Masaaki Kodama, Kazunari Murakami, Kyoichi Adachi, Nobuyuki Matsuhashi, Ken Ohata, Toshikazu Ushijima, Mototsugu Kato, Shin'ichi Miyamoto, Daisuke Yoshimura, Takashi Yao, Kazuyoshi Yagi, Moriya Iwaizumi, Naomi Uemura
Format: Article
Language:English
Published: Wiley 2024-04-01
Series:DEN Open
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Online Access:https://doi.org/10.1002/deo2.345
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author Masaaki Kobayashi
Junko Fujisaki
Ken Namikawa
Shu Hoteya
Akiko Sasaki
Kotaro Shibagaki
Kenshi Yao
Seiichiro Abe
Ichiro Oda
Hiroya Ueyama
Hajime Isomoto
Masanori Ito
Mitsushige Sugimoto
Takashi Kawai
Masaaki Kodama
Kazunari Murakami
Kyoichi Adachi
Nobuyuki Matsuhashi
Ken Ohata
Toshikazu Ushijima
Mototsugu Kato
Shin'ichi Miyamoto
Daisuke Yoshimura
Takashi Yao
Kazuyoshi Yagi
Moriya Iwaizumi
Naomi Uemura
author_facet Masaaki Kobayashi
Junko Fujisaki
Ken Namikawa
Shu Hoteya
Akiko Sasaki
Kotaro Shibagaki
Kenshi Yao
Seiichiro Abe
Ichiro Oda
Hiroya Ueyama
Hajime Isomoto
Masanori Ito
Mitsushige Sugimoto
Takashi Kawai
Masaaki Kodama
Kazunari Murakami
Kyoichi Adachi
Nobuyuki Matsuhashi
Ken Ohata
Toshikazu Ushijima
Mototsugu Kato
Shin'ichi Miyamoto
Daisuke Yoshimura
Takashi Yao
Kazuyoshi Yagi
Moriya Iwaizumi
Naomi Uemura
author_sort Masaaki Kobayashi
collection DOAJ
description Abstract Objectives Gastric cancer can be diagnosed even in patients long after Helicobacter pylori eradication. Most cases involve intramucosal lesions; however, some are invasive and require surgery. To clarify appropriate long‐term surveillance methods, this study compared invasive gastric cancer diagnosed ≥10 and <10 years after eradication. Methods This retrospective multicenter study included 14 institutions. We included 377 patients with gastric cancer with submucosal or deep invasion after surgical or endoscopic resection. Ordered logistic regression analysis was used to explore the factors contributing to the pathological stage and histological type. Results Invasive gastric cancer was detected in 84 patients (Group L) and 293 patients (Group S) ≥10 and <10 years after H. pylori eradication, respectively. Endoscopic mucosal atrophy at the time of cancer detection was similar in both groups; 50% of the patients had severe atrophy. Annual endoscopy correlated with early pathological stage (odds ratio [OR] 0.28, 95% confidence interval [CI] 0.14–0.54, p < 0.001). Group L exhibited an independent correlation with the advanced pathological stage (OR 2.27, 95% CI 1.06–4.88, p = 0.035) and the undifferentiated type (OR 2.12, 95% CI 1.16–3.90, p = 0.015). The pure differentiated type and early pathological stage significantly (p = 0.001) correlated with severe mucosal atrophy in Group S but not in Group L. Conclusions Invasive cancers diagnosed ≥10 years after H. pylori eradication were likely to be more malignant in histological type and pathological stage. Gastric cancer surveillance should continue regardless of endoscopic atrophy, particularly ≥10 years after eradication.
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spelling doaj-art-730c3f48bbe844c5ad935deca6cac5d82025-08-20T02:55:03ZengWileyDEN Open2692-46092024-04-0141n/an/a10.1002/deo2.345Multicenter study of invasive gastric cancer detected after 10 years of Helicobacter pylori eradication in Japan: Clinical, endoscopic, and histopathologic characteristicsMasaaki Kobayashi0Junko Fujisaki1Ken Namikawa2Shu Hoteya3Akiko Sasaki4Kotaro Shibagaki5Kenshi Yao6Seiichiro Abe7Ichiro Oda8Hiroya Ueyama9Hajime Isomoto10Masanori Ito11Mitsushige Sugimoto12Takashi Kawai13Masaaki Kodama14Kazunari Murakami15Kyoichi Adachi16Nobuyuki Matsuhashi17Ken Ohata18Toshikazu Ushijima19Mototsugu Kato20Shin'ichi Miyamoto21Daisuke Yoshimura22Takashi Yao23Kazuyoshi Yagi24Moriya Iwaizumi25Naomi Uemura26Division of Gastroenterology Niigata Cancer Center Hospital Niigata JapanDepartment of Gastroenterology Cancer Institute Hospital Japanese Foundation for Cancer Research Tokyo JapanDepartment of Gastroenterology Cancer Institute Hospital Japanese Foundation for Cancer Research Tokyo JapanDepartment of Gastroenterology Toranomon Hospital Tokyo JapanGastroenterology Medicine Center Shonan Kamakura General Hospital Kanagawa JapanDepartment of Endoscopy Shimane University Hospital Shimane JapanDepartment of Endoscopy Fukuoka University Chikushi Hospital Fukuoka JapanEndoscopy Division National Cancer Center Hospital Tokyo JapanEndoscopy Division National Cancer Center Hospital Tokyo JapanDepartment of Gastroenterology Juntendo University School of Medicine Tokyo JapanDepartment of Multidisciplinary Internal Medicine Division of Gastroenterology and Nephrology Tottori University Faculty of Medicine Tottori JapanDepartment of General Internal Medicine Hiroshima University Hospital Hiroshima JapanDepartment of Gastroenterological Endoscopy Tokyo Medical University Hospital Tokyo JapanDepartment of Gastroenterological Endoscopy Tokyo Medical University Hospital Tokyo JapanDepartment of Gastroenterology Faculty of Medicine Oita University Oita JapanDepartment of Gastroenterology Faculty of Medicine Oita University Oita JapanHealth Center Shimane Environment and Health Public Corporation Shimane JapanDepartment of Gastrointestinal Endoscopy NTT Medical Center Tokyo Tokyo JapanDepartment of Gastrointestinal Endoscopy NTT Medical Center Tokyo Tokyo JapanInstitute for Advanced Life Sciences Hoshi University Tokyo JapanNational Hospital Organization Hakodate National Hospital Hokkaido JapanDepartment of Gastroenterology National Hospital Organization Kyoto Medical Center Kyoto JapanDepartment of Gastroenterology National Hospital Organization Kyushu Medical Center Fukuoka JapanDepartment of Human Pathology Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Gastroenterology and Hepatology Uonuma Institute of Community Medicine Niigata University Medical and Dental Hospital Niigata JapanClinical Laboratories Hamamatsu University School of Medicine Shizuoka JapanDepartment of Gastroenterology Kohnodai Hospital National Center for Global Health and Medicine Chiba JapanAbstract Objectives Gastric cancer can be diagnosed even in patients long after Helicobacter pylori eradication. Most cases involve intramucosal lesions; however, some are invasive and require surgery. To clarify appropriate long‐term surveillance methods, this study compared invasive gastric cancer diagnosed ≥10 and <10 years after eradication. Methods This retrospective multicenter study included 14 institutions. We included 377 patients with gastric cancer with submucosal or deep invasion after surgical or endoscopic resection. Ordered logistic regression analysis was used to explore the factors contributing to the pathological stage and histological type. Results Invasive gastric cancer was detected in 84 patients (Group L) and 293 patients (Group S) ≥10 and <10 years after H. pylori eradication, respectively. Endoscopic mucosal atrophy at the time of cancer detection was similar in both groups; 50% of the patients had severe atrophy. Annual endoscopy correlated with early pathological stage (odds ratio [OR] 0.28, 95% confidence interval [CI] 0.14–0.54, p < 0.001). Group L exhibited an independent correlation with the advanced pathological stage (OR 2.27, 95% CI 1.06–4.88, p = 0.035) and the undifferentiated type (OR 2.12, 95% CI 1.16–3.90, p = 0.015). The pure differentiated type and early pathological stage significantly (p = 0.001) correlated with severe mucosal atrophy in Group S but not in Group L. Conclusions Invasive cancers diagnosed ≥10 years after H. pylori eradication were likely to be more malignant in histological type and pathological stage. Gastric cancer surveillance should continue regardless of endoscopic atrophy, particularly ≥10 years after eradication.https://doi.org/10.1002/deo2.345endoscopic resectiongastric cancer surveillancemucosal atrophypathological stageundifferentiated type
spellingShingle Masaaki Kobayashi
Junko Fujisaki
Ken Namikawa
Shu Hoteya
Akiko Sasaki
Kotaro Shibagaki
Kenshi Yao
Seiichiro Abe
Ichiro Oda
Hiroya Ueyama
Hajime Isomoto
Masanori Ito
Mitsushige Sugimoto
Takashi Kawai
Masaaki Kodama
Kazunari Murakami
Kyoichi Adachi
Nobuyuki Matsuhashi
Ken Ohata
Toshikazu Ushijima
Mototsugu Kato
Shin'ichi Miyamoto
Daisuke Yoshimura
Takashi Yao
Kazuyoshi Yagi
Moriya Iwaizumi
Naomi Uemura
Multicenter study of invasive gastric cancer detected after 10 years of Helicobacter pylori eradication in Japan: Clinical, endoscopic, and histopathologic characteristics
DEN Open
endoscopic resection
gastric cancer surveillance
mucosal atrophy
pathological stage
undifferentiated type
title Multicenter study of invasive gastric cancer detected after 10 years of Helicobacter pylori eradication in Japan: Clinical, endoscopic, and histopathologic characteristics
title_full Multicenter study of invasive gastric cancer detected after 10 years of Helicobacter pylori eradication in Japan: Clinical, endoscopic, and histopathologic characteristics
title_fullStr Multicenter study of invasive gastric cancer detected after 10 years of Helicobacter pylori eradication in Japan: Clinical, endoscopic, and histopathologic characteristics
title_full_unstemmed Multicenter study of invasive gastric cancer detected after 10 years of Helicobacter pylori eradication in Japan: Clinical, endoscopic, and histopathologic characteristics
title_short Multicenter study of invasive gastric cancer detected after 10 years of Helicobacter pylori eradication in Japan: Clinical, endoscopic, and histopathologic characteristics
title_sort multicenter study of invasive gastric cancer detected after 10 years of helicobacter pylori eradication in japan clinical endoscopic and histopathologic characteristics
topic endoscopic resection
gastric cancer surveillance
mucosal atrophy
pathological stage
undifferentiated type
url https://doi.org/10.1002/deo2.345
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