2022 Volume 60 Issue 4 Pages 639-649
Purpose: This study aimed to clarify the characteristics of gastric cancer detected years after Helicobacter pylori (H. pylori) eradication therapy and determine the surveillance period required following H. pylori eradication, focusing on post-eradication gastric cancer detected by gastric endoscopy screening.
Subjects and methods: Among 289 gastric cancers detected from April 2009 to October 2019, 45 after H. pylori eradication (44 early-stage cancers and one advanced cancer) were included in the study. Annual trends in the detection rate of gastric cancer after H. pylori eradication were investigated, and clinicopathological findings were evaluated. In addition, clinicopathological characteristics between gastric cancers detected within 5 years and more than 10 years following H. pylori eradication were compared.
Results: The detection rate of gastric cancer after H. pylori eradication gradually increased each year, accounting for 34.2% of all gastric cancers detected in the past 4 years. The majority of the patients were male, and the types of cancer were mainly depressed (0-IIc) and differentiated, occurring in the middle and lower regions of the stomach. Thirty (66.7%) cases of gastric cancer detected within 5 years of H. pylori eradication showed moderate to severe mucosal atrophy. The incidence of differentiated-type cancers is high. In contrast, nine (20.0%) cases of gastric cancer detected more than 10 years after H. pylori eradication showed mild to moderate mucosal atrophy, and undifferentiated lesions accounted for more than half of the cases (five of the nine [55.6%] cases).
Conclusion: More than 10 years after H. pylori eradication, 20% of patients were detected with gastric cancers, indicating that continuous long-term monitoring after H. pylori eradication is necessary. Further, the frequency of detecting undifferentiated carcinoma increased against a background of mild to moderate gastric mucosal atrophy.
