Effect of Helicobacter pylori infection on survival outcomes of patients undergoing radical gastrectomy after neoadjuvant chemotherapy: a multicenter study in China

Effect of Helicobacter pylori infection on survival outcomes of patients undergoing radical gastrectomy after neoadjuvant chemotherapy: a multicenter study in China

Abstract Background Neoadjuvant chemotherapy (NAC) has been confirmed to improve the prognosis of patients with advanced gastric cancer (AGC). However, no study has investigated whether Helicobacter pylori (HP) infection affects the postoperative survival of patients who receive NAC. Methods This re...

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Main Authors: Qi-Chen He, Ze-Ning Huang, Chen-Bin Lv, Yong-He Wu, Wen-Wu Qiu, Yu-Bin Ma, Ju Wu, Chang-Yue Zheng, Guo-Sheng Lin, Ping Li, Jia-Bin Wang, Jian-Xian Lin, Mi Lin, Ru-Hong Tu, Chao-Hui Zheng, Chang-Ming Huang, Long-Long Cao, Jian-Wei Xie
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Cancer
Subjects:
Neoadjuvant chemotherapy
Helicobacter pylori
Gastric cancer
Gastrectomy
Online Access:https://doi.org/10.1186/s12885-025-13840-7
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Summary:Abstract Background Neoadjuvant chemotherapy (NAC) has been confirmed to improve the prognosis of patients with advanced gastric cancer (AGC). However, no study has investigated whether Helicobacter pylori (HP) infection affects the postoperative survival of patients who receive NAC. Methods This retrospective cohort study included 307 patients with AGC who underwent laparoscopic radical gastrectomy after NAC at three hospitals in China between January 1, 2016, and April 31, 2020. Cox regression was used to assess prognostic factors for survival. Kaplan–Meier was used for survival analysis. Results The HP + and the HP- group included 141 and 166 cases. The 3-year overall survival (OS) and disease-free survival (DFS) of the HP + group were significantly better than the HP- group (3-year OS: 75.9% vs. 60.2%, 3-year DFS: 70.2% vs. 52.3%; All P < 0.001). For the HP + group, ypTNM Stage III (HR, 4.00; 95% CI, 1.11–14.39; P = 0.034), NAC ≥ 4 cycles (HR, 0.43; 95% CI, 0.20–0.90; P = 0.026), and adjuvant chemotherapy (AC) ≥ 4 cycles (HR, 0.20; 95% CI, 0.09–0.48; P < 0.001) are independent prognostic factors for OS. In the cohort of HP + patients who received ≥ 4 cycles of NAC, the prognosis of patients who received ≥ 4 cycles of AC after surgery was better than that of patients who received < 4 cycles of AC (3-year OS: 92.5% vs 71.4%; P = 0.042). Conclusions Following NAC, HP + patients with AGC exhibit better prognosis than that of HP- counterparts. For potentially resectable HP + AGC patients, radical surgery following ≥ 4 cycles of NAC with ≥ 4 cycles of sequential AC might be recommended to improve survival.
ISSN:1471-2407

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